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Cutting-edge products and solutions for your customers

2014 Equipment

Guide

For Dental Sales Professionals September 2014

For Dental Sales Professionals June, 2010A partnered publication with Dental Sales Pro • www.dentalsalespro.com

S p E C i a l E q u i p m E n t i S S u E

4 : September 2014 : First Impressions : www.firstimpressionsmag.com

September 2014 • Issue 5


EquipmentGuide

8p.10 Chairs

p.14 Intraoral Cameras

p.16 Ultrasonic Scalers

p.17 Cabinets

p.18 Handpieces

p.20 Nitrous Oxide

p.26 Overhead Lighting

p.28 Sterilizers

p.33 Dry Vacuum Systems

p.34 Digital Radiography

• Who created the first and only company to sell dental implants exclusively through dental dealers?

• Who will provide you the biggest sales growth opportunity you’ve ever had in your career?

• Who will provide you the opportunity to sell into a $1.5 billion existing market that is forecasted to grow 70% over the next 5 years?

• Who can add $250,000-$750,000 of annual sales in your territory within 3 years?

• Who will provide you with the support of a local surgical implant sales specialist?

• Who will provide you with live and online implant sales training?

• Who will provide your clients all levels of education and CEUs live and online?

• Who will provide you with innovative patented implant products and accessories that compete and beat the prices of all direct selling implant companies?

• Who is the leading dental implant advertiser that will create leads and brand awareness?

• Who can provide you with implants that are surgically and prosthetically compatible with the leading implant brands that have sales of over $1 billion annually?

• Who will provide you with patient education software that will allow your clients to gain greater consent on implant cases?

Attention Dental Sales Professionals

idsmegagen.com 866-277-5662

Mega'Gen® • AnyRidge® • AnyOne® • AnyWhereTM • DentalMasterTM • ReflectTM

COMING FALL 2014

FirstImpressions7.5x10.indd 1 5/16/14 2:29 PM

Equipment


First Impressions is published bi-monthly

by mdsi

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Lawrenceville, GA 30043-8153

Phone: 770/263-5257

FAX: 770/236-8023

www.firstimpressionsmag.com

Editorial Staff

Editor

Mark Thill

[email protected]

Senior Editor

Laura Thill

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Managing Editor

Graham Garrison

[email protected]

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Brent Cashman

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Brian Taylor

[email protected]

Sales

Bill Neumann

[email protected]

Monica Lynch

[email protected]

Circulation

Wai Bun Cheung

[email protected]

First Impressions (ISSN 1548-4165) is published

bi-monthly by Medical Distribution Solutions

Inc., 1735 N. Brown Rd. Ste. 140, Lawrenceville,

GA 30043-8153. Copyright 2013 by Medical

Distribution Solutions Inc. All rights reserved.

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note: The acceptance of advertising or products

mentioned by contributing authors does not

constitute endorsement by the publisher. Publisher

cannot accept responsibility for the correctness of

an opinion expressed by contributing authors.

p.36 The Makings of a Great Equipment Rep

Don Hobbs shares his perspective based on a quarter century of experience

p.40 Climate for Financing The market is good, rates

are low, banks are willing to lend

p.46 News

46 40

36

“ the most challenging thing for any equipment rep is finding out, ‘Doctor, what do you want to look like three, five, 10 years from now?’ the answer to that question will direct the discussion in a meaningful way.”

Your Smile. Our Vision. www.sdi.com.auwww.sdilearning.com

SDI (North America), Inc.729 N. Route 83, Suite 315Bensenville, IL 60106, USA

Toll free: 1800 228 5166Fax: 630 238 9200 [email protected]

Aura: THE DENTAL ADVI-SOR, Vol 31, No. 4, May 2014.

1. Demonstrate Aura in a tooth model so

doctors can feel the great handling of Aura

2. Shades mimic the natural tooth and

recognized for excellent shade blending

3. Bulk fill components available

4. Aura is the only microfill utilizing

modern technology not sold direct

An innovative restorative system designed to save time, every time!

Key Selling Tips:

GET $10 FOR EVERYSTARTER KIT SOLD

$50cash voucher

DENTIST BUYS 10 REFILLS & RECEIVES A FREE RADII PLUS

REPRESENTATIVE RECEIVES $50 FOR EACH SALE

OR

DEALS VALID JULY 1 - DECEMBER 31

2014

=

Your Smile. Our Vision. www.sdi.com.auwww.sdilearning.com

SDI (North America), Inc.729 N. Route 83, Suite 315Bensenville, IL 60106, USA

Toll free: 1800 228 5166Fax: 630 238 9200 [email protected]

Aura: THE DENTAL ADVI-SOR, Vol 31, No. 4, May 2014.

1. Demonstrate Aura in a tooth model so

doctors can feel the great handling of Aura

2. Shades mimic the natural tooth and

recognized for excellent shade blending

3. Bulk fill components available

4. Aura is the only microfill utilizing

modern technology not sold direct

An innovative restorative system designed to save time, every time!

Key Selling Tips:

GET $10 FOR EVERYSTARTER KIT SOLD

$50cash voucher

DENTIST BUYS 10 REFILLS & RECEIVES A FREE RADII PLUS

REPRESENTATIVE RECEIVES $50 FOR EACH SALE

OR

DEALS VALID JULY 1 - DECEMBER 31

2014

=



2014 Equipment

Guide

because clean matters.

A lot of companies toss around words like “quality” and “reliability” without putting anything

behind them. We don’t. In fact, that’s why we offer the best warranty program in the industry.

We continue to be a leading brand in a category we created back

in the 1950s. That’s a long time on top, and we’ve worked very

hard to stay there. A great example is the incredibly quiet, newly

designed Effi ca™ E1 Ultrasonic Cleaning System with its custom

basket included and optional automatic locking cover. That’s why

L&R continues to be the brand you can trust.

Patients Trust Their Dentists.

Dentists Trust Us.

www.LRultrasonics.com/effi ca • 866.567.8811

L&R Ultrasonics • 577 Elm Street • Kearny, NJ 07032

LRU7005-1_FirstImpressions.indd 1 7/22/14 11:38 AM


Equipment Guide

Straining and twisting to reach the patient can be a major source of discomfort and fatigue for den-tists. The right chair can eliminate these problems

by allowing dentists to work as close as possible to the oral cavity, while keeping their patients calm and relaxed. Features such as conveniently located integrated touch pads and thin chair backs allow the patient to be reclined closer to the operator’s knees, eliminating reaching and twisting. Today’s chairs offer advanced chair controls for easier adjustment, and armrests that drop down, permit-ting dentists to move closer to their patients. Features such as 60-degree rotation and height flexibility also contribute to enhanced ergonomics and better access to patients. Wireless technology (e.g., wireless foot con-trols and remote mounted touchpads) has helped remove much of the cluttered look associated with operatories of years past and reportedly makes it easier for dentists to position the chair for patients.

Chairs

Editor’s note: First Impressions would like to thank DentalEZ® for its assistance with this piece.

in a busy practice. Regardless of the type or length of the procedure, the right chair solution can contribute to a pos-itive experience for both dentists and patients.

Probing sales questions • What chair do you currently use?• What stool are you using?• What stool is your assistant using?• How do you practice?

(Are you two-handed or four-handed?)• How does you assistant sit?• What type of delivery system do you use?• What do you like (and not like) about your current

equipment?• Are you experiencing any pain?

New products NuSimplicity Chair. Features include: Thin tapered back, slim 12-3/4” width at top of chair back; integrated touch pads located on both sides of upper backrest; simple chair controls including Auto Return, Last Position, 3 pre-sets and manual settings; slim, wider cantilever for ease of internal umbili-cal; height from 15”-35.5” that accommodates sit-down and stand-up dentistry; 60-degree rotation for positioning.

Preventive maintenance tips• It is important to read

the instructions from the manufacturer and follow manufacturer guidelines when disinfecting.

At the same time, the slimmer look of new-er chairs doesn’t mean they aren’t built to last. Some offer a lift capacity up to 500 pounds to

accommodate a range of patients and withstand heavy daily use

Upgrade your Operatory with Flexible Positioning & LED Technology from DentalEZ®!

EverLight®With 100% true LED technology, the EverLight® enables you to work with more precise, direct light.

NuSimplicity™ ChairMinimizing twisting & reaching with ergonomic access to the oral cavity, the NuSimplicity™ Chair makes positioning easy with its height flexibility.

www.DentalEZ.com

EverLight®

NuSimplicity™ Chair

Simplicity® Stools

NextGen® Team Work Station

Follow Us!

©2014 DentalEZ, Inc. DentalEZ, EverLight, NextGen and Simplicity are registered trademarks and NuSimplicity is a trademark of DentalEZ Inc.


Equipment Guide

T he look and feel of a chair determines patients’ com-fort and, in turn, their perception of the practice. Quality dental chairs range in price from $7,000 to

$12,000, with high-end chairs offering greater ranges of high/low motion; greater access; stronger construction to accommodate heavier or obese patients; additional accesso-ries and options; tight-fitting components that are easier to clean and maintain; and sleeker styling, with polished covers and fewer seams, to reflect the image of the practice.

Probing sales questions • Do your patients fidget in the chair? • Do your patients ever mention that they are cold?

Chairs

Editor’s note: First Impressions would like to thank Midmark for its assistance with this piece.

• Do your patients have to move around in the chair as you move it? Do you find they are readjusting themselves because their shirt or blouse is pulling out as they recline, or is their head not in the head-rest when you lay them back?

• How old are your chairs?• Are your patients increasing in size? Are they

getting older? Are any of your patients special needs patients?

• Do you ever have to use posture supports or pil-lows to help patients feel comfortable?

• Do you or anyone in your office experience back pain or problems? Do you find yourself stretching during the day to get back relief ?

• Do you anticipate doing expanded procedures or having patients who require longer procedures, such as full-arch or whole-mouth restorations?

• Can you stand during your extractions when using your current chairs? Do you wish you could make the chair lower for some of your procedures?

• Have you ever cracked your knee on a rotation brake of the chair, or hit yourself against the armrests?

• Which chair in the office do you most dislike, and why? • Which chair in the office is your favorite, and why

is it so?

New products Midmark Elevance® Dental Chair. Developed with both the patient and operator in mind, the Elevance® Den-tal Chair combines sophisticated styling with optimal ac-cess for the operator and exceptional patient comfort. For more information, please visit www.midmark.com.

Preventive maintenance tips • Follow the manufacturer’s recommended guidelines

for cleaning and maintenance.

Experience our family.

Midmark’s innovative family of equipment sets a new standardin design, function, flexibility and aesthetics for your office.

For more information, contact your Midmark Sales Representative.

midmark.com1-800-MIDMARK


Equipment Guide

When used in conjunction with a computer or television monitor, intraoral cameras provide dentists and their staff with infor-

mation to better communicate recommended proce-dures to their patients. Dentists can show patients their oral cavity when suggesting restorative, hygienic or esthetic procedures. The more thoroughly patients are educated about necessary treatments, the more likely they will be to follow through. And, once the treatment is completed, with an intraoral camera, dentists can show patients before-and-after images for comparison.

When properly maintained, today’s intraoral cam-eras can work well for over 10 years. Loss of image quality, burned-out LED lights or physical damage, such as cracks, signify equipment needs to be replaced. Thanks to advances in technology, intraoral cameras offer some advantages over their predecessors, includ-ing the replacement of halogen bulbs with LED lights. By eliminating fiber optic parts associated with halo-gen bulbs, intraoral cameras have become more reliable and easier to maintain. In addition, the LED camera handpiece is said to be smaller and lighter and has a lifespan of about 50,000 hours, compared with 50 hours provided by halogen-based systems. And, LEDs and fluorescence technol-ogy reportedly make it more efficient to detect real-time caries, plaque tartar and gingival inflammation.

Some dentists may be concerned about the cost of purchasing an intraoral camera. While there is a wide price range, when it comes to intraoral cameras, dentists get what they pay for. By purchasing a less expensive mod-el, they risk sacrificing quality and efficiency. That said, a good camera should pay for itself within a month or two.

Probing sales questions • Are you interested in ways to increase your office revenue?• What are you currently doing to increase care acceptance?• Are you aware of how an intraoral camera can help

you educate your patients about the importance of following through with certain treatments?

New products SoproCARE. SoproCARE gives the dental pro-fessional a new visual tool to educate the patient on the importance of good dental hygiene and periodontal health. Utilizing fluorescence tech-nology, SoproCARE illuminates dental tissue to reveal occlusal caries, plaque, tartar and gingival inflammation. SoproCARE can be used as an in-traoral camera, providing the dental professional with the necessary tools to perform a complete and time-efficient oral examination. SoproCARE is Windows- and MAC-compatible and functions in nearly all imaging software applications, al-lowing images to be easily saved in the patient’s chart. SoproCARE is compatible with current and previous SOPRO docking stations. SoproLIFE. SoproLIFE provides greater accu-racy in indentifying, evaluating and determining the location of a carious lesion with image magni-fication of 30 to 115 times. SoproLIFE offers the ability to detect tooth decay at different stages of

its development to determine the most effective course of treatment. With the push of a button the blue LED lights are activated and variations in the amelodentinal architecture result in visible color changes to the tooth’s image. During diagnosis, the auto fluorescence technolo-gy in SoproLIFE detects occlusal or interproximal decay, even in its earliest stages, which can often be missed by x-rays. During treatment, SoproLIFE clearly differentiates healthy tissue from infected tissue in order to excavate only the affected areas.

Preventive maintenance tips Intraoral cameras do not need any maintenance if they are used according to the manufacturer’s use and cleaning in-structions. Infection control procedures must be observed when handling the camera. Protective camera sheaths must be used in order to prevent cross contamination risk from one patient to another.

Editor’s note: First Impressions would like to thank Acteon for its assistance with this piece.

Intraoral Cameras


Equipment Guide

Piezoelectric ultrasonic scalers are a very versatile type of dental device that can perform a variety of appli-cations, such as supra-gingival scaling, sub-gingival

periodontics, endodontics, and restorative procedures. The scaler achieves ultrasonic vibrations from piezo-ceramic discs stacked in the scaler handpiece. When these discs are excited by electricity, they begin to oscillate at a very high frequency in the range of 20 – 40 kHz. The displacement caused by the oscillation is converted by a transducer to vi-brations in the tip that is connected. Piezoultrasonic scalers produce a linear vibration in the tips, which provides a num-ber of benefits to clinicians as well as patients, including:

• The ability to control the vibrations and have a large range of tips for multiple procedures. Dentists can choose from extremely thin tips for sub-gingival periodontics; diamond coated tips for canal access preparation in endodontics; very thick, bladed tips to remove tenacious calculus; and tips for post removal.

• The ability to make tips that resemble hand instru-ments so they can be used in the same fashion. The piezoelectric ultrasonic scaler handpiece can be used the same way as its manual handpiece counterpart.

• The ability to control the vibrations, which also provides more comfort for patients, regardless of the procedure.

• Because the tip is vibrating ultrasonically, cavita-tion is also being produced. This provides addi-tional biofilm disruption, as well as superior canal disinfection during passive ultrasonic irrigation.

• Linear vibrations also make the device capable of restorative procedures, such as margin preparation, inlay/onlay preparation, caries preparation and veneer preparation.

Probing sales questions • Would you be interested in an ultrasonic device that

can be used for scaling as well as endodontics and restorative procedures?

• What are you currently using as your ultrasonic scaling device?

• What endodontic procedures are you performing? Piezoelectric ultrasonics can perform endodontic retreatment, passive ultrasonic irrigation and apical surgery.

• Are you aware that a piezoelectric scaler can perform restorative procedures, such as inlay and onlay preparation?

New products • The PURE NEWTRON range from ACTEON

North America offers color-coded tips that cor-respond to a matching colored power level on the device for efficient treatments and the best results.

• The new B.LED handpiece for the PURE NEWTRON range is all titanium so it is lighter, more ergonomic and has an LED light that produces 100,000 Lux of bright white light for better visibility.

• The PURE NEWTRON range of ultrasonic scal-ers has a glass top and removable power knob for superior infection control. The PURE NEWTRON range also offers independent irrigation tanks for use of any irrigant, such as water or medicaments such as chlorhexidine

Preventive maintenance tips • Clean and sterilize the handpiece after each patient use.• Monitor the tips as you use them. When the ef-

ficiency starts to diminish, order new ones. Some companies offer tip wear cards to let you know when its time to replace them.

Ultrasonic Scalers

Editor’s note: First Impressions would like to thank Acteon for its assistance with this piece.

www.firstimpressionsmag.com : First Impressions : September 2014 : 17

CabinetsBecause dental practices are

specialized treatment facilities, they have needs that are pro-

fession- and practice-specific. Dental cabinetry must be aesthetically pleas-ing, while addressing these needs by providing designs that meet ergonom-ic workflow, infection control, tech-nology integration and unique storage requirements. They must be built with quality materials and components to be able to withstand the demands of the healthcare environment.

Probing sales questions • Do you have a lot of clutter

on your countertops?• Are all supplies and ancillary

devices easily within reach during a treatment procedure?• Does your staff have to leave the operatory to retrieve

supplies or equipment during treatment procedures?• Do you use CPUs and monitors in each operatory?• What plans do you have to incorporate new tech-

nology or equipment in the future?• Would you like the option to take your cabinets with

you if you ever move locations?• How old are your current cabinets? Do they reflect the

image you want to portray to your patients and staff?• How important is the décor of your office?• Do your patients comment on your office appear-

ance today? If “yes,” what do they say? If “no,” do you wonder why they don’t comment?

New products Artizan® Expressions by Midmark is the ideal balance between expressive design and function that will forever transform the dental space. The new line breaks the stereo-

type of dental cabinetry with one-of- a-kind designs. Fea-tures like the treatment station slim profile midsection with cantilever-forward upper; the central station vanity front; re-cessed sink; and the Ultraleather accents make the Artizan® Expressions line nearly impossible to recreate, even by the most talented cabinetmaker. The new Artizan cabinetry also offers maximum design flexibility by allowing customers to combine several cabinet and resin panels, countertop ma-terials and upholstery colors to create a look that is distinc-tively their own. Midmark has collaborated with designers to create specific palettes that will help customers choose color combinations that express their individual style – everything from the desirable traditional elements to an impressive contemporary design.

Preventive maintenance tips • Make sure the cabinets are level at installation.• Keep hinges adjusted for proper door and

drawer alignment.



Equipment Guide

A handpiece is the engine of the dental office. If it were not for handpieces, the dental office would not function. There are two types of handpieces

currently in the market: Air-driven handpieces. Air-driven handpieces use com-pressed air from the dental unit to spin an impeller in the head of the handpiece, which spins a bur up to speeds exceeding 400,000 rpm. The speed created by the impeller of an airdriven handpiece allows the dentist to cut tooth structure. As the den-tist applies pressure to cut tooth structure, the bur speed slows. Often, a dentist will use a “feathering” technique. This means that as the bur speed slows, the dentist will re-move pressure from the bur and tooth to allow the handpiece to return to the original speed. Electric handpieces. An electric handpiece uses electricity to generate power to tooth structure. Electric handpieces are still connected to the dental unit air and water lines to receive coolant air and water spray, which cools the bur and tooth structure. A highspeed electric handpiece runs at approximately at 200,000 rpm, which is slower than an air-driven handpiece. However, since electric power is used to spin the bur, unlike an air-driven handpiece, a feathering technique is not required to cut the tooth. Regardless of the pressure applied by the dentist, a properly functioning elec-tric highspeed will continue to spin at 200,000 rpm. Electric handpieces are a milling tool; as such, they are much more efficient at cutting tooth structure than airdriven handpieces.

Probing sales questions Could you please show me the protocol that you use to maintain handpieces? (It is important for the sales rep to know the proper protocols for both automated and man-ual handpiece maintenance, from the time the procedure has ended until the handpiece is placed into the sterilizer. Often, with staff turnover or improper/lack of training,

the proper protocol is not followed. When the proper pro-tocol is not followed, sales reps should ask:

• How frequently do you change the cartridges in your highspeed handpieces?

• How frequently do you have your handpieces repaired?• Do you keep a log of those repairs? (The average handpiece is repaired once a year. However, if sales reps are able to review the office repair log, they will probably find that some handpieces have been repaired multiple times in a year. The cost of repairs, which can be expensive, sometimes go un-noticed in a dental office. Reps might find that multiple hand-piece repairs exceed the cost of a brand new handpiece.)

New products • SANAO Electric Attachments. The next generation

of electric attachments by SciCan. Sanao handpiec-es are fast, with a patented resin to help prevent de-bris build up (HPS resin), and they are ergonomic.

• E-STATIS Advantage & Prep electric motor systems. Both of these systems come with the E-STATIS SLM motor and a user-friendly touchscreen. The SLM is only 2.6 inches in length and weighs only 62 grams, and the touchscreen is customizable to the dentist’s procedures.

• STATMATIC handpiece maintenance unit. The Statmatic, which comes with a 10-year warranty, cleans, lubricates and purges handpieces, making the office more efficient.

Preventive maintenance tips If a dental practice lubricates the handpiece, the handpiece must always be purged prior to sterilization. If it is not purged, the lubricant will bake onto the components of the handpiece during sterilization, and it will lead to premature handpiece failure.

• With fixed-back handpieces, the dental practice must al-ways lubricate the smaller of the two large holes/tubes. This is the drive air line, which leads to the turbine or cartridge of the handpiece. The larger hole is the hand-piece exhaust. If the larger hole/tube is lubricated, the turbine or cartridge is not being properly maintained.

Handpieces

Editor’s note: First Impressions would like to thank SciCan for its assistance with this piece.


High-speed electric handpieces can run at 200,000 rpm, while high-speed air-driven devices function at up to 400,000 rpm and usually operate within

180,000 rpm to 330,000 rpm. Power and torque have im-proved as well. For instance, many handpieces available to-day have more than 20W power, which was unheard of 10 years ago. In addition:

• Head sizes have been reduced for better visibility and access.

• Fiber-optic lighting and LED have been integrated into handpieces, improving the dentist’s ability to view the treatment area.

• Air-driven handpiece cartridges feature enhanced longevity and reduced noise with ceramic bearings.

• Innovative materials, such as titanium bodies, have made it possible to repeatedly sterilize the handpiece without compromising its performance or lifespan.

• Chucking mechanisms now feature push-button releases to make the insertion and the removal of burs fast and simple.

• Ergonomic improvements have made handpieces more comfortable, better balanced and easier for the dentist to hold.

Both air driven and electric handpieces cost between $399 and $1,499. (Air-driven handpieces usually cost less than elec-tric.) Dentists may be concerned about the cost of replacing their handpieces, but by spending less, they risk sacrificing:

• Power• Optics• Ceramic bearings, which help ensure longer turbine life• 360˚ swivel• Lighter weight• Better ergonomics• More water ports for more consistent and effective

cooling of the treatment area• Anti-heat generation systems (a feature of electric handpieces)• Mechanisms designed to prevent entry of oral

fluids into the handpiece head

• Visibility and access• Reduced noise

Probing sales questions • What type of handpieces do you prefer using?

Air driven, electric or both?• How old are your current handpieces, and how

often do you need to repair them? (Some dentists continue to repair old devices, rather than replacing them, risking patient safety.)

• How many operatories do you have and what ap-plications are you using handpieces for?

• What problems are you experiencing with your current handpieces?

New products • Ti-Max Z900L/Z800L. The most powerful air driven

handpiece on the market today, with 26W of power (Z900L) and 23W of power with the mini head Z800L.

• Ti-Max Z45L. The world’s first 45-degree electric handpiece, with a unique feature that allows chip air to be turned on so that the handpiece can function both as a surgical handpiece and as a standard high speed handpiece with improved access.

• iCare. A four-port handpiece maintenance system with enhanced lubrication and cleaning ability and a unique chuck cleaning function.

Preventive maintenance tips • Lubricate and clean the handpiece immediately after

each use (and before autoclaving) with a spray lubri-cant or automated handpiece maintenance system to maximize turbine lifespan in air-driven handpiec-es and gear lifespan in electric handpieces.

• Clean each handpiece chuck weekly with a spray lubricant or automated handpiece maintenance sys-tem to prevent burr lock or slippage and to ensure consistent performance.

Handpieces

Editor’s note: First Impressions would like to thank NSK Dental for its assistance with this piece.


Equipment Guide

Nitrous oxide and oxygen delivery systems are typi-cally used in dental offices to assist with patient anxiety, as well as potentially achieve minimal se-

dation to help relax/comfort patients during dental treat-ments. Nitrous oxide is also very beneficial for manage-ment of pediatric patients.

The main components of the system are the flowme-ter and the breathing circuit. The flowmeter – the device that mixes the nitrous oxide – allows the dentist to pre-cisely control the gas mixture and flow (or volume) that is administered to the patient. Some flowmeters are calibrat-ed by percentage, allowing the user to automatically adjust the mixture based on a percentage indicator on one of

the control valves. Other flowmeters are non-percentage, meaning the user must calculate the percentage mixture in his or her head. Percentage flowmeters are most com-monly used today.

All flowmeters have diameter-indexed connections, preventing the potential for gas lines being crossed. All flowmeters in use today are REQUIRED to have an oxy-gen fail-safe. This prevents the potential for 100 percent nitrous oxide from being administered to a patient, which could be fatal. If a flowmeter in service can flow nitrous oxide without oxygen, it should immediately be removed from service. This is a simple test that anyone can check. Simply try to flow N2O without any O2 flowing. The oxy-gen fail-safe, which is often taken for granted, should be checked on a regular basis.

The breathing circuit is the tubing that allows the gas mixture from the flowmeter to be inhaled and ex-haled by the patient. The patient inhales and exhales through a nasal hood. The exhalation is scavenged away through a hose that is typically connected to the HVE in the operatory.

There are several different varieties of breathing cir-cuits available, and not all function the same way. Some are more efficient at both administration and scavenging of the waste gas. Some nasal hoods are marketed as fun for the patient, but overlook the efficiency (or lack thereof) of scavenging. Clinical studies are available for potential customers looking for data on which nasal hoods are the most efficient for scavenging.

Nasal hoods are available in single use disposable or autoclavable options.

Probing sales questions Some dentists only offer what their patients ask for. They forget that patients usually don’t know what to ask for. The same goes for nitrous oxide. If dentists don’t recommend their patients use nitrous oxide, very few will ask for it. Nitrous oxide allows patients to have a more pleasant ex-perience; enables dentists to complete the procedure more

Nitrous Oxide

Porter has added two new nitrous oxide sedation systems that will make it easier and more efficient than ever to expand your proposal options. Increase your business withPorter – the market leader for nitrous oxide systems.

SSeenntrtryySedate is a sleek and modern portable, 4 cylinder system that features a duallocking cabinet for secure storage, a working top surface and larger wheels for easiermovement between operatories.

The Porter Digital MDM has the smallest footprint of any cabinet-mount flowmeter systemand features multiple mounting options for flexible positioning and ease of installation.

For more information, contact Porter, visit our website or our listing on DSP Connect.

New Nitrous Oxide Systems From

The Trusted Name In Nitrous

www.porterinstrument.com/dental888-723-4001

Porter SSeenntrtryySedate

Porter Digital MDMSide View Only 1.25” Depth

Dimensions7 7/8” W2 3/4” H1 1/4” D


Equipment Guide

efficiently; and helps with increasing re-care and patient referrals. Sales reps should ask their customers:

• Do you treat children?• Do you often see patients that are phobic or have

anxiety about their dental treatment?• Do you perform invasive procedures?• Do you have difficulty with patient compliance for

local injections?• Do you wish you could complete more dentistry in

fewer patient visits?• Would you be interested in implanting something

with a high ROI?

Editor’s note: First Impressions would like to thank Porter Instrument for its assistance with this piece.

If your customers answer yes to any of the above, they are potential candidates for the use of nitrous oxide.

New products Porter has introduced two exciting new products this past year:

• The Sentry Sedate is the newest portable nitrous system. It provides added security with locking doors, yet it’s a significant cosmetic improvement over traditional portable nitrous systems. The ugly gas cylinders are no longer an eye sore to patients.

• The Porter Digital MDM is the smallest cabi-net mount flowmeter system in the industry. As cabinet space becomes a greater premium, Porter delivers the ideal solution, shipped with multiple mounting options. When cabinet space is a prob-lem, the Porter Digital MDM is the solution.

Preventive maintenance tips • Systems should be checked regularly to ensure

proper function.• Breathing circuits, breathing bags and hoses should

be inspected for cracks, holes, missing parts etc. Breathing circuits are not meant to last forever. If you see one taped together or discolored, this is an opportunity to suggest replacement to the office.

• The oxygen fail-safe and emergency air intake valve should be tested regularly.

• Flowmeter calibration can sometimes be field-tested, or the flowmeter may have to be sent in for testing, depending on the manufacturer.

• Always review the manufacturer suggested main-tenance in the device user manual for suggested routine maintenance.

The oxygen fail-safe and emergency air intake valve should be tested regularly.


Nitrous oxide can be an asset to the dental practice – provided dentists use the equipment properly and know when to have it serviced. By working

closely with their customers, distributor sales reps can ensure they get the most value from their equipment.

If dentists have one misconception about nitrous oxide and how it works, it’s that the gas puts patients to sleep. In actuality, nitrous oxide enables patients to relax in a state of conscious sedation. A blend of two gases – oxygen and nitrous oxide – nitrous ox-ide must be comprised of at least 30 percent oxygen and no more than 70 percent nitrous oxide. The gas runs into a precise flow meter, which feeds into a scaveng-ing device to the patient (through a nasal hood). Because the gas can enter – and leave – the patient’s bloodstream relatively quickly, it takes effect almost immediately and, following the procedure, the patient can leave the dental office on his or her own.

One of the greatest advantages to using nitrous ox-ide is that it helps reduce patients’ fear or anxiety prior to a procedure. It is well tolerated, has a rapid onset and is reversible. In addition, it can be adjusted in various concentrations and is non-allergenic. And yet, rather than offer it to their patients, many dentists wait for their patients to request it. Sales reps should remind them that it not only could help improve the patient experience, but that it’s also an additional source of rev-enue for their practice.

Probing sales questions • Do you – or have you ever – offered nitrous oxide se-

dation to your patients for a relaxed dental experience?

• Are you aware that nitrous oxide sedation (mild sedation) is associated with an almost immediate recovery, allowing patients to leave the dental office unaccompanied?

• Along with marketing new technology and prod-ucts, have you noticed that today many dental of-fices are marketing nitrous oxide conscious sedation (mild sedation) or sleep sedation (moderate to deep sedation and general anesthesia) to their patients? Websites and mailers are successfully being used as marketing vehicles.

• If you are considering implementing nitrous oxide, and plan to use it frequently, you might want to consider installing a central system. Central sys-tems use large E cylinders of gas, which in the long run are a more cost-effective option than portable systems that utilize smaller cylinders. If you think that you will use nitrous oxide selectively and are considering a portable system, a 4-cylinder option vs. a 2-cylinder option will ensure that a second tank of gas is always available.

New products Accutron manufactures a complete line of analog and digital nitrous oxide portable and central system

Nitrous Oxide

One of the greatest advantages to using nitrous oxide is that it helps reduce patients’ fear or anxiety prior to a procedure. It is well tolerated, has a rapid onset and is reversible.


Equipment Guide

flowmeters and manifold systems, along with a full line of emergency equipment. The company also man-ufactures a large selection of nasal hoods, including autoclavable and single-use nasal hoods. Its recently introduced low-profile ClearView Single-Use Nasal Hoods have both scented and unscented inner hoods and a clear outer hood that shows condensation when a patient is breathing through his nose.

ClearView is available in Classic design and as a CO2 Capnography Nasal Hood. The ClearView CO2 Cap-nography Nasal Hood has a side tube with a Luer Lock port that can be attached to a Capnograph machine for monitoring end-tidal carbon dioxide. The American As-sociation of Oral and Maxillofacial Surgeons (AAOMS) has recently revised its guidelines to include monitoring end-tidal CO2 during moderate to deep sedation; state regulations are expected to follow accordingly. Samples of Accutron’s single-use nasal hoods can be requested at www.accutron-inc.com. All Accutron products are avail-able through Accutron-authorized dental distributors.

Preventive maintenance tips• Scavenger goods, such as rubber bags and tubing

used to deliver nitrous oxide, can crack or tear with repeated usage. When that happens, the gas cannot be delivered effectively, detracting from the patient experience. In addition, leaks from the tears and cracks can cause gas to be released into the ambient air, repeatedly exposing staff and other patients to trace nitrous oxide.

• Gas can leak at any place of connection on the equipment. This includes the manifold and wall con-nections and any hoses associated with each.

• The soap and water method for determining leaks is recommended for inspecting the areas mentioned above. The presence of bubbles after application of the soapy water solution indicates that there is a gas leak. Sales reps should remind their customers to pe-riodically test for leaks and tears, and to be diligent about replacing rubber goods every year or two (or as needed) should a leak be detected.

• There are several ways that nitrous oxide can leak from patients. One of the most critical measures to control is patient talking. When a patient talks, ni-trous oxide is expelled into the operator’s breath-ing zone. Periodically remind the patient to breathe through his/her nose and request that he/she mini-mize talking. Patients that are mouth breathers are probably not ideal candidates for nitrous oxide.

• An ill-fitting nasal hood is also a potential source for gas leakage. A snug, comfortable fit creates a de-sirable seal around the patient’s nose. In addition, a low-profile hood reduces the tendency for the pa-tient to break the seal when attempting to make ad-justments in order to see the clinician better or to watch a large screen TV that might be situated in the dental operatory. Low-profile nasal hoods have significant benefits to the clinician as well in that they tend to expand their field of view, making it easier and more efficient to perform dental procedures.

Editor’s note: First Impressions would like to thank Accutron for its assistance with this piece.

There are several ways that nitrous oxide can leak from patients. One of the most critical measures to control is patient talking. When a patient talks, nitrous oxide is

expelled into the operator’s breathing zone. Periodically remind the patient to breathe through his/her nose

and request that he/she minimize talking.

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Equipment Guide

Proper positioning of the operatory light has the light line and eye line within 15 degrees of each other. For the lower anterior lingual, the best ac-

cess is slightly from behind. For the lingual surface of the posterior teeth, the light should be 15 degrees to the side. For both mandibular and maxillary, the light must be in the patient’s mid-sagital plane, directly above or slightly behind the patient’s oral cavity.

Overhead Lighting

Editor’s note: First Impressions would like to thank DentalEZ® for its assistance with this piece.

Why LED? • Environmentally friendly.• Energy efficient.• Longer life.• Cool light.• Green technology.

Probing sales questions • Do you lose productivity and get fatigued

by improper lighting? • Did you know that proper lighting equals over

20 percent enhanced production?• Do you know how to position operatory lighting

correctly to minimize shadows and dark areas?

New products The EverLight® from DentalEZ® features three Kelvin Color Temperatures and three Lux Intensity Settings, with 12 LEDs.

• Technology maximizes the light-emitting area, resulting in brighter, more efficient and more robust LEDs.

• Produces the most usable light.• Produces white light.• Cool Light, no fan required.• No reflector needed.

Preventive maintenance tips • Use a non-alcoholic commercial cleaner solution,

or a mild soap-and-water solution, to wipe the light down.

For both mandibular and maxillary, the light must be in the patient’s mid-sagital plane, directly above or slightly behind the patient’s oral cavity.


Overhead lighting can play an important role in ensur-ing quality dentistry. Proper

lighting not only provides the clini-cian with better visibility into the oral cavity, but it also has the ability to help with color matching, all the while helping to reduce eye strain on the part of the clinician. Dental lights often come with different intensity settings as well as different modes that help reduce curing time when working with composites. Having different intensity settings is impor-tant in order to have the light bright enough to properly illuminate the oral cavity, but not so bright that it creates a larger contrast between the oral cavity and the ambient lighting, which can create eye fatigue. The emergence of LED tech-nology means that bulbs no longer have to be changed, are much cooler to the touch compared to halogen lights, and consume less power. LED lights also allow for better control over a set color temperature (color temperature on halogen lights tends to vary when adjusting the intensity), as well as other options that can be utilized to reduce the effect of curing composites when working with them.

Probing sales questions • Do you have adequate lighting when working

in the oral cavity?• Do you have any issues with eye fatigue/eye strain?• How good is your ability to color match composites

with your current light?• Do you use your light when working with

composite material?

• How old are your lights?• Does your light give off unwanted heat?• How often do you have to replace light bulbs?

New products Midmark Dental LED Operatory Light: The Midmark LED Operatory Light is a market-driven solution utilizing cutting edge LED technology to provide the ultimate ex-perience in dental lighting. It provides true, reduced shad-ow white light you need to properly match shades, identify details and diagnose tissue. The Midmark LED offers a feathered edge to help minimize eye strain. All of this is accomplished while using only 22 watts of electricity.

Preventive maintenance tips Follow the manufacturer’s recommended guidelines for cleaning and maintenance.

Overhead Lighting



Equipment Guide

The most common method of sterilization in the den-tist’s office is steam, or autoclaving. (Other methods include dry heat sterilization and chemical vapor ster-

ilization.) To achieve optimal sterilization conditions inside the chamber of a steam sterilizer, it is necessary to remove the air trapped inside the chamber once the sterilizer door is closed.

There are three types of steam sterilizers:• Gravity displacement. Gravity displacement units rely

on gravity to force trapped air out of the bottom of the chamber through a valve at the beginning of the cycle, as the heat builds. With this type of sterilizer there is the potential for small pockets of air to remain trapped in the top crown of the chamber after the valve closes, causing incomplete sterilization.

• Steam flush pressure pulse. In a steam flush pressure pulse sterilizer, an electronic solenoid valve is used to expel air and steam during heat-up. These sterilizers are pre-programmed to optimize sterilization parameters.

• Fractionated steam sterilizers (pre- and post-vacu-um). Fractionated steam (pre- and post-vacuum Class B) sterilizers use a vacuum pump to remove air from the chamber during heat-up. This technology report-edly results in a more rapid and deeper dispersal of steam, with fewer cold spots. Pre-vacuum refers to the use of the vacuum pump to the chamber, which sucks out air from the chamber before steam is in-jected. This level of complexity is typically not nec-essary. Post-vacuum refers to the use of the vacuum pump to suck out the remaining steam and moisture at the end of the cycle, as the drying process begins, thereby speeding up the drying process.

Probing sales questions • How old is your sterilizer? Does it reach and maintain

the correct temperature/pressure for sterilization?• Has your unit failed in the past, forcing you to ob-

tain a loaner or to delay or postpone procedures?

• Do you or your staff have to constantly monitor its parameters?

• Do you use cassettes, or do you plan to use them in the near future?

• If it appears that a new sterilizer is in order, reps might ask:• How many instruments will you need to

sterilize each day?• How large are your instruments? • What method will you use to clean your

instruments prior to sterilization? (e.g., ultrasonic, instrument washer)

• How many patients do you see in a typical day?• What type of electrical wiring exists in your office? • How large an area exists in the practice to

accommodate a sterilization center?

New products • Statim 2000 G4 and Statim 5000 G4. The Statim

is the dental industry standard for fast, effective and gentle sterilization cycles. The new G4 technology interface allows the Statim to be on the office network while archiving, requesting and receiving service and software upgrades remotely. Dental offices find that their expensive instruments and handpieces will look great and operate flawlessly for years.

• Bravo 17V. Bravo is available in 120V and 220V in both a 10-inch 17-liter and 21-liter chamber size. Features such as intelligent closed-door drying and a pull-and-push water system make Bravo easy to oper-ate. With extremely fast wrapped cycles, the Bravo is the round chamber sterilizer for today’s dental office.

Preventive maintenance tips • Bravo 17V. Wipe out the Bravo chamber with a moist

towel and check the filter screen twice each week.• Statim. Clean the Statim cassette once each week with

a ScotchBrite pad and water. Use any one of the fol-lowing cleaners: Cameo, Zud or Bar Keepers Friend.

Sterilizers

Editor’s note: First Impressions would like to thank SciCan for its assistance with this piece.

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Equipment Guide

T here are several types of sterilizers available: steam sterilizers (autoclaves), dry heat sterilizers, heated chemical vapor sterilizers, and gas sterilizers. (The

majority of dental practices in the United States utilize steam sterilizers, or autoclaves.)

Tabletop steam sterilizers range in chamber size from 7 inches to 15 inches in diameter. The Centers for Disease Con-trol and Prevention (CDC) guidelines call for regular monitor-ing of the working steam sterilizer by doing a weekly spore test.

Air is removed from the chamber in a steam steriliz-er, either by gravity displacement or by a vacuum pump. Gravity displacement means that through the natural forces of gravity, steam pushes air to the top of the chamber and out of the chamber. Steam sterilizers with a vacuum pump rely on a vacuum pump to pull the air out of the chamber.

Sterilizersproduce steam. The steam forces any air in-side the chamber to the top of, and out of, the chamber, either through a valve or an air jet. This process of removing the air and leaving only steam in the chamber is essential to the operation of the steam sterilizer.

• The autoclave, which is controlled by the tempera-ture and pressure sensor, heats to the proper tem-perature and pressure. As the pressure builds within the chamber, the air is continuously expelled from the chamber. (Steam temperature has a direct and important correlation to steam pressure. At every level of pressure, steam has a specific correspond-ing temperature; this is a universally accepted fact. There is one stipulation required to make this true: there must be 100 percent steam present. For this

reason, it is important that the air be removed as completely as possible from the chamber. Removing the air is what allows the temperature to rise properly inside the chamber.)

• Once the correct temperature is reached, the timer counts down the programmed amount of sterilization time. Steam contin-ues to purge out of the chamber as is needed to eliminate any dif-ferences of temperature that can occur within the chamber.

• The autoclave exhausts and the drying part of the cycle begins.

• At the end of drying, sterilization is complete.

Probing sales questions Since all practices use an autoclave, any practice is a can-didate for a new autoclave. There are many sterilizers that haven’t been replaced in years. Offices that have increased their volume are excellent candidates for a larger or more advanced unit. Sales reps should ask:

To achieve sterilization, certain parameters must be met for air removal, temperature and pressure. Without meeting all of these parameters, sterilization cannot be achieved. Most dental offices utilize a gravity displacement steam sterilizer (autoclave). Basic operation of a fully automatic gravity displacement autoclave is as follows:

• The operator loads the autoclave, closes the door, selects the proper program and presses start.

• Water flows into the chamber.• Water inside the autoclave chamber is heated to

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Equipment Guide

• How old is your sterilizer? (Since all offices utilize a sterilizer, a good probing question would be, Is it time to replace your sterilizer?)

• What model sterilizer are you replacing? (The answer will give the sales rep a good indication of the type of sterilizer the office is comfortable us-ing and the chamber size it currently has.)

• Does your current model sterilizer meet all the needs in the office?

• Does the office need to change from a manual to a fully automatic autoclave? (This often is done to free up time for the staff to work more closely with patients, performing or assisting in proce-dures that add to the bottom line.)

• Has the volume of items to be sterilized increased, decreased or remained the same? (This indicates to sales reps whether they should present a larger, smaller or equivalent chamber size).

• This discussion will open communication with the customer and help sales reps determine the best possible fit for each dental office with regard to workflow and throughput.

New products Tuttnauer offers a full line of autoclaves and accessories for dental and medical professionals in the largest range of chamber sizes to meet all needs. Its manual autoclaves set the standard for steam sterilization and remain the benchmarks in the industry. They are available in 7-inch, 9-inch, 10-inch and 15-inch diameter chamber sizes and are backed by a one-year parts and labor warranty. The fully automatic EZ models, available in 9-inch, 10-inch and 15-inch diameter chamber sizes, feature active closed-door drying, meaning the door stays closed through the dry cycle. With one touch, the autoclave fills, heats up, sterilizes, exhausts and dries – all with the door closed. This is critical since closed-door drying maintains sterility by encouraging staff to not handle wet items, which can lead to contaminating the load. The drying part of the cycle is quite important and pouches, packs and cassettes should always be dried inside the sterilizer. (It is recom-mended to comply with CDC guidelines stating “Instru-

ment packs should be allowed to dry inside the sterilizer chamber before removing and handling. Packs should not be touched until they are cool and dry because hot packs act as wicks, absorbing moisture, and hence, bac-teria from hands.” Guidelines for Infection Control in Dental Health-Care Settings, 2003.)

Tuttnauer is currently the only manufacturer to offer closed-door drying on a gravity displacement steam steril-izer and to supply a two-year parts and labor warranty on a fully automatic autoclave.

Preventive maintenance tips • Regular cleaning and maintenance of a sterilizer is

critical to keeping the device in good working con-dition. Establish – and follow – a regular cleaning schedule according to manufacturer directions in the operator’s manual. A specific staff member should be responsible for cleaning the autoclave on a regular basis, and the doctor or office man-ager should follow up to ensure that the sterilizer is, in fact, being cleaned.

• Do not overload the sterilizer trays. Over-loading sterilizers is the number one cause of sterilization cycle failures, including inadequate sterilization and drying. All staff should be trained on – and understand – proper loading. Correct loading permits efficient air removal from the chamber; permits steam penetration and saturation; and ensures proper drainage of condensate. When using pouches, do not over-lap or stack the pouches. Place pouches on trays in a single layer, or use a pouch rack to ensure proper steam penetration and adequate drying. Surfaces that are hidden when items are over-lapped or stacked will not be exposed to the steam and will not be sterilized. (Selling oppor-tunity: If the volume is such that pouches are being stacked, the office clearly requires a larger chamber or multiple sterilizers.)

• Always use steam-distilled water with the physical characteristics detailed in the sterilizer manufac-turer’s operator’s manual.

Editor’s note: First Impressions would like to thank Tuttnauer for its assistance with this piece.


Dry vacuums today deliver higher suction power, re-gardless of the number of

users. They can be easily controlled – from 8 to15 inHg. Advanced dry vacuums are designed to adjust the frequency of the pump(s) to main-tain the required vacuum level, de-pending on the needs of the dental facility. In multiple pump systems, the workload is balanced such that every pump receives reduced work and increased life. In addition, some dry vacuums virtually elimi-nate water use and dramatically re-duce power consumption.

Probing sales questions • How old is your current

vacuum system?• How often does your current vacuum

system break down?• Are you experiencing increases in your water

bill with your current wet vacuum system?• Has your state mandated water restrictions?• How much time and money do you spend

maintaining your current system?• Do you experience loss of suction? If so, how often?

New products The new Mojave V15 series is designed for clinics, hos-pitals, dental schools and large practices. Engineered to be installed in up to four parallel units to support 60 users, if your customers need more, they can add another four, and so on.

Preventive maintenance tips • Mojave has been designed to make maintenance

easy. No filters to replace. No traps to drain. The company recommends the use of Monarch CleanStream™ Evacuation System Cleaner on a daily basis to break down and eliminate the buildup that occurs in the vacuum lines.

• CleanStream is designed based on Air Techniques’ 40 years of vacuum pump experience to effectively and efficiently remove debris build-up and maxi-mize the life and performance of the vacuum. It is the only cleaner the company recommends.

Dry Vacuum Systems

Editor’s note: First Impressions would like to thank Air Techniques for its assistance with this piece.

In multiple pump systems, the workload is balanced such that every pump receives reduced work and increased life.


Equipment Guide

Digital Radiography A convenient workflow offered by a chairside digital

radiography system produces immediate radio-graphs in nine seconds or less. The user must sim-

ply remove the flexible phosphor sensor from the patient’s mouth, remove the sensor from the infection control bar-rier envelope and insert it into the slot at the top of the unit. The scanner will develop the image, and the sensor will be available for reuse.

Editor’s note: First Impressions would like to thank Air Techniques for its assistance with this piece.

Probing sales questions • What are you using in your practice to

produce digital images?• If you use wired sensors, what back-up system do

you use for patients with small mouths, difficulty in opening wide, or gag reflexes?

• How much do you pay for chemicals or annual insurance?• How often have you broken the wire to your

direct sensor?• How important is patient comfort to you?

New products • ScanX Swift.• ScanX Barrier Envelope

#2 Bulk Pack.

Preventive maintenance tips • There are no annual mainte-

nance costs with ScanX Swift. Included with the system are sen-sor cleaning wipes for cleaning the reusable phosphor sensors; barrier film roll for adhering to the top of the scanner before inserting the PSP and removing in between patients; and scanner cleaning sheets for keeping the system’s rollers clean.

There are no annual maintenance costs with ScanX Swift.

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• ScanX has the same sizes and workflow as film—no new protocol required; plus, flexible phosphor sensors are positioned with existing XCP holders.

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sales

The Makings of a Great

Equipment RepDon Hobbs shares his perspective

based on a quarter century of experience

Don Hobbs attended his 25th Chicago MidWinter earlier this year. For the past quarter century, he has learned a lot about dental equipment sales. The first half of his career was spent on the wholesale side of the business, as a field rep, national sales manager and independent rep. Thirteen years ago,

he joined Henry Schein as a regional manager, just as Schein was making its transition from catalog merchandise company to full service distributor. Today, Hobbs is vice president of equipment and technology sales for Henry Schein Dental. First Impressions spoke with him recently about the role of the equipment rep in today’s dental market.


First Impressions: What makes a great equipment sales rep today?Don Hobbs: That’s a huge question. Today’s equipment rep is much differ-ent than an equipment rep of five, 10 or 15 years ago. In the past, the natu-ral transition was, service technician first, then for some, transition to an equipment rep. Service technicians know and understand the equipment and the doctors trust them. Many of our most successful equipment spe-cialists started as service technicians.

Today’s equipment specialists need to have a wide variety of skills. They have to act as general contrac-tor, balancing many different pieces in order to complete a project. They need to be a banker, able to talk about financing, lease negotiations and real estate. They need to understand equipment clinically, and from a work-flow perspective. They have a much

more detailed responsibility than equipment reps in the past. They are truly partnering with their customers and becoming a trusted consultant. They are involved from the start of a project and are side by side with the doctor building a three-, five- and 10-year plan. It has evolved from the nuts and bolts of the past, so to speak.

First Impressions: The word “equip-ment” can refer to digital imag-ing, practice management software, chairs and furniture, etc. Do Schein’s reps specialize? Hobbs: We have evolved into the equipment and technology specialist – or ETS – model. Even as recently as a few years ago, we had three different types of reps – equipment specialists, software/technology specialists, and CAD/CAM specialists. We’ve com-bined those resources in an effort to

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sales

reduce the complexity of new projects. So, rather than bringing several different people into the office for a proj-ect, we have tried to consolidate, to make things easier for the customer.

We’ve been able to do that, in part, because today’s buyer is different than those of the past. They are educated buyers; they’ve done their homework on the Internet; they know what they want. This is especially true for dentists graduating from dental school today. So you have a much more educated buyer, and you have to adapt to that buyer. And at the same time, we feel it’s important to reduce the complexity of what can be a very complicated process.

First Impressions: Any difference in the sales approach for an office setup vs. a renovation or replacement equip-ment purchase?Hobbs: We look at equipment sales in one of three ways: Is the customer building, remodeling or moving? Each begs a different sales process. If you ask the right ques-tions during the discovery phase, you will find out what the doctor really wants to do. The rep has to understand the doctor’s vision. The most challenging thing for any equip-ment rep is finding out, “Doctor, what do you want to look like three, five, 10 years from now?” The answer to that question will direct the discussion in a meaningful way.

It’s not uncommon for us to sit down with a doctor who still practices in the colonial house that his or her

father or grandfather practiced in. It’s tradition, and many emotions are involved. We know it’s impossible for the doctor to generate a profit without adequate space. In the past we would recommend that doctors needed three treatment rooms and two hygiene rooms to be profitable. We knew the math. But dentistry has evolved, and now we recommend that all the rooms are consistent and designed as full treatment suites. That concept enables doctors to treat some patients immediately, as opposed to re-appoint-ing. It is better for the patient, as they do not have to come back, and it is better for the doctor, as it leads to a more ef-ficient and profitable practice. During the discovery phase, if we ask the right questions, the doctor will often come to the same conclusion. “You know, I need a bigger space.” Once you get past the emotions, you’re having a whole new discussion.

First Impressions: To what extent does today’s rep rely on the equipment manufacturer to know and present de-tails of the product?Hobbs: At Schein, we expect our equipment and technol-ogy specialists to be experts on the equipment they sell. That said, often our customers expect to meet the manu-facturer reps. They’re spending a lot of money on digital imaging equipment, for example, and they want to know that person, they want to know the company. In those situ-ations, the partnership between the distributor rep and the

“ Service is such an important aspect of what we do. In how many other industries do you see service technicians walking around with the keys to customers’ offices on their belt?”


manufacturer rep is critical; they lean on each other for product expertise, detailing and inservicing.

But some customers prefer us to simplify what can be a complicated sales process. They don’t want too many people involved. In those cases, our reps do most of the work themselves. They become the primary contact and the primary resource for the dentist. So there’s a wide gam-ut in the way we work with our supplier partners.

First Impressions: How about the interaction between the distributor sales rep and the service technician? Has that changed in the past five or 10 years?Hobbs: No, it hasn’t really changed. Service is such an important aspect of what we do. In how many other in-dustries do you see service technicians walking around with the keys to customers’ offices on their belt? Our den-tal customers trust their service techs so much they hand them the keys to their office.

Before buying a piece of equipment, one of the last things the doctor does is ask his or her favorite service tech, “Am I doing the right thing?” That tech’s answer better be consistent with what the rep is selling the doc-tor. So that relationship has to be very good, very strong. I tell our reps all the time, “If you don’t have the ser-vice business with a customer, you’re vulnerable.” The reps who respect that, understand that and work that, are more successful. FI

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First Impressions visited with Ray Doherty, president and CEO of Healthcare Professional Funding, Boston (a subsidiary of the Bank of Maine), which specializes in servic-ing the dental market. In last year’s Equipment Issue, Doherty pointed out that for sales reps, the discussion about financing flows naturally once the dentist understands how a piece of equipment can help him or her save time, streamline processes or increase the number of dental proce-dures performed by the practice. Fol-lowing are Doherty’s thoughts about equipment acquisition and financing in 2014 and 2015.

First Impressions: Last year you said that dentists who seek financing will likely find it. “The market is good. Rates are very low now. The banks are out there trying to lend.” What’s the climate today?Ray Doherty: It’s really the same. The two most critical things are the cred-itworthiness of the doctor and the fi-nancial health of the practice. Lenders that are putting money into a practice

Climate for FinancingThe market is good, rates are low, banks are willing to lend

Equipment salespeople know that selling any kind of equipment – clinical, IT or basic equipment, such as chairs – involves not just selling its clinical, ergonomic or cosmetic attributes, but also the potential revenues it might generate, as well as its affordability.

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finance

want to know, “Can this practice generate the cash flow nec-essary to pay us back?” If the answer is “yes,” the doctor should have no problem getting financing.

First Impressions: Last year, your company was seeing an increase in the demand for its services. At the time, den-tists were improving, enhancing and updating their prac-tices, not merely to improve productivity, but to improve their appearance. What, if anything, has changed in the past 12 months?Doherty: We see that many practices are expanding, par-ticularly in areas where there are shortages of dentists. Reps should never miss the opportunity to talk to their customers about equipment when practices are in transi-tion, that is, undergoing expansion, renovation or a move.

Distributors are no doubt finding technology equipment sales, such as EMR, are strong, as dentists look to increase their productivity and throughput. Sales of basic equip-ment, like chairs, may be lagging a little. But, as I said last year, in an image-conscious age, new chairs and office fur-niture are important.

First Impressions: Last year you spoke about the typi-cal dentist’s three primary goals – to save time, streamline processes, and increase the number of procedures. Have their goals changed since we last spoke?Doherty: Not at all. There’s a shortage of dentists today, for a number of reasons: More Baby Boomers are visit-ing their dentist; there’s a growing recognition that oral care is an important part of overall healthcare; and now, because of Obamacare, kids’ dental care is covered by in-surance. All of these things come together, and you can see the future is bright for dentists – if they can handle

the additional patient base. Dentists have more teeth to service, and they want to be chairside as much as possible. They want to save time for themselves and everyone else in the practice. This affects the sales rep’s approach. “Doc-tor, with this equipment, you can save an hour a day; that could mean extra patients.” Milling machines, which allow the dentist to perform an entire procedure in one sitting; digital X-ray systems; and practice management software are all in demand.

First Impressions: Last year you saw an increased de-mand for refinancing. Is that still true today? And what’s the opportunity for sales reps?Doherty: We see a lot of refinancing by doctors, and when they refinance, they often buy additional equipment. There’s

a good reason for refinancing. Den-tists just starting out pay a higher rate of interest on their loans, be-cause they lack a track record. Two or three years later, they have that track record, and they seek refinanc-ing for a lower rate. The same is true for doctors who are expanding their practice; they may wait for a year or two following expansion before seeking refinancing. But again, mon-

ey is available in today’s market, so long as the dentist is creditworthy and has a healthy practice.

First Impressions: What is the status of Section 179? Last year, this provision of the tax law allowed businesses to immediately deduct as much as $500,000 as an expense for purchases made in 2013.Doherty: Congress refused to extend the Section 179 de-duction of $500,000 into 2014. So, effective Jan. 1, 2014, Section 179 was restored to its $25,000 limit plus adjust-ments for inflation. That means, as things stand today, the dentist can immediately deduct just $25,000 for an equip-ment purchase. That amount decreases dollar for dollar for every dollar over $200,000 plus adjustments for infla-tion. In other words, a dentist buying $225,000 worth of equipment has no Section 179 deduction at all.

The other big change is bonus depreciation. Last year, that bonus depreciation amounted to 50 percent of everything

We see a lot of refinancing by doctors, and when they refinance, they often buy additional equipment.

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finance

over the Section 179 amount. In other words, once you de-pleted the Section 179 tax deduction, you got 50 percent of that overrun as an immediate tax deduction. That is now gone, effective Dec 31, 2013.

It’s possible Congress could reinstate the $500,000 Section 179 limit and bonus depreciation, and they could make it retroactive to Jan. 1, 2014. But that certainly wouldn’t happen before the November elections.

First Impressions: Last year, you made the comment that the rep has to help the customer understand how a piece of equipment will benefit the practice. Has the way in which reps help customers come to that understanding changed? Should it?Doherty: Let’s say you’re trying to sell a cone beam or milling machine. To do so, the rep has to show the doctor that he or she can make money by putting that piece of equipment in the office. Our company has a worksheet on our website that allows the dentist to calculate the break-even point on a new piece of equipment, and its potential to generate profits. The breakeven point is higher this year, because of the changes in Section 179. That makes the rep’s selling job more difficult. It also demonstrates how important it is for the rep to understand how taxes will affect the doctor.

First Impressions: Anything else to add about how dis-tributor sales reps can help their customers obtain financ-ing for new equipment?Doherty: As I said last year, when it comes down to it, the fine art of discussing financing hasn’t changed in years. It begins with this: Don’t try to sell the customer until you know the customer – who they are, what they need, what they want.

The rep has to understand the mathematics of equip-ment acquisition, and how the doctor will look at those mathematics. The doctor wants to know, “How will this equipment benefit me?” For that reason, the rep has to know how to help the doctor perform a breakeven analysis.

The rep also has to understand the tax consequences of the purchase, because it will come up. He or she can help the doctor envision how a new piece of equipment will fit into the practice, and how it will help the doctor manage his expanding practice better, deliver revenue, and allow him or her to perform more dentistry. But as I said last year, reps should urge their customers to consult with their tax advisor prior to making any decisions based on tax law.

Again, the most important thing is this: Don’t go into the office cold. Understand the equipment the doctor is looking at, and how that equipment will help him or her. Once the dentist understands that, the rest is easy. FI

Reps should never miss the opportunity to talk to their customers about equipment when practices are in transition, that is, undergoing expansion, renovation or a move.

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Henry Schein, athenahealth expand strategic agreementHenry Schein and athenahealth Inc, a provider of cloud-based services for EHR and practice manage-ment, announced an expansion of their strategic agree-ment announced on May 21, 2014. Under the expanded agreement, athenahealth’s athenaNet® platform and Henry Schein’s Dentrix® Enterprise, an Electronic Dental Record (EDR) solution installed in Commu-nity Health Centers (CHCs) across the United States, will integrate to facilitate Uniform Data System (UDS) reporting, which is a requirement for CHCs, including Federally Qualified Health Centers (FQHCs). For more information, go to www.henryschein.com

DentalEZ® Group announces new appointeesDentalEZ® Group announced several recent appointments. Kevin Curran was recently named territory sales manager. In his new position, Curran will be re-sponsible for fostering existing profes-sional relationships while identifying new prospects to increase all StarDental®, DentalEZ®, RAMVAC® and Custom-Air® product and equipment sales. His sales territory spans throughout several northern regions including western New York, western Pennsylvania, northeast Ohio and West Virginia (with the excep-tion of the city of Huntington.) He will report directly to Mark Frankenfield, northern regional manager for DentalEZ Group. Curran brings over 15 years of professional dental sales experience to his new position. Prior to joining DentalEZ Group, he held a variety of positions within Patterson Dental Companies.

Gina Verkamp recently joined DentalEZ as Institu-tional Sales Representative. In her new position as Institu-tional Sales Representative for DentalEZ Group, Verkamp will report directly to Greg Morton, Western Regional Manager. Verkamp will be responsible for maintaining ex-isting professional relationships and developing new pros-pects and additional DentalEZ Group sales for regional

government and educational institutions. Her territory will cover the entire west coast region.

William King also joined DentalEZ Group as territory sales manager for the regions of North Carolina, Southern Virginia, West Virginia and Northern South Carolina. In his new position, King will be responsible for fostering existing professional relationships while identifying new prospects to increase all DentalEZ Group product and equipment sales.

ACTEON wins 2014 Pride Institute, Best in Class Technology Awards for SoproCARE and Newtron P5 XSACTEON North America won the 2014 Pride Insti-tute, Best in Class Technology Awards for SoproCARE and Newtron P5 XS, according to a release. Tim Long, VP/COO for ACTEON North America said, “This is a very prestigious award for the dental industry and to win it with both the SoproCARE and Newtron P5 XS B.LED is extra special. We are honored to be rec-ognized as having great technology to offer clinicians to help their practices and patients every day.” A pan-el, comprised of leading voices in dental technology, comes together each year to discuss, debate and decide what products merit recognition. The panel consists of five dentists with significant knowledge of and ex-perience in dental technology.

Midmark running M3 Ultrafast® Dental Sterilizer Promotion Midmark Corporation is running a M3 Ultrafast® Dental Sterilizer Promotion. For each sterilizer purchased from an authorized dental distributor during the promotional period, the dentist or dental facility is eligible to receive a $500 rebate. The M3 is designed to sterilize unwrapped instruments and handpieces in just six minutes, and pouched instruments in just over 10 minutes, with just a touch of a button. Features such as a 25-minute drying time, one-step loading, automatic water monitoring, and front reservoir drain make the M3 a top choice among practitioners. Important promotional dates include:

• Order period: July 1- Sept. 30, 2014• Dentist’s shipment and invoice date must be

between: July 1- Oct. 15, 2014• Must claim incentives by: Oct. 31, 2014

Gina Verkamp

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news

Bill Bambic, Territory Representative Bill Bambic joins Benco Dental in the Blue Ridge region. The Ohio University graduate will call on customers in Raleigh and Dur-ham, N.C. He brings three years experience in the dental industry to the position.

Sara Breland, Territory RepresentativeSara Breland joins Benco Dental’s team in the Piedmont region. Breland, a University of South Alabama graduate, will call on cus-tomers in Mobile and Baldwin County, Ala-bama and Pensacola, Florida.

Kate Brongo, Territory Representative Benco Dental is pleased to welcome Kate Brongo to its Empire region. She will call on customers in Rochester, New York. Brongo, a graduate of SUNY Empire State College, brings more than five years experience as a dental assistant to the position.

John Butcher, Territory Representative The Benco Dental team in the Sooner region welcomes John Butcher. He will call on cus-tomers in Tulsa and Tahlequah, Oklahoma. Butcher brings three years of dental sales ex-perience to the position.

Richard Anthony Covington, Territory Representative Richard Anthony Covington joins Benco Dental in the Mississippi region. The gradu-ate of Mississippi State University will call on customers in Hattieburg, McComb, and Monroe, Mississippi.

Julie Didier, Territory Representative Julie Didier is now part of Benco Dental’s Mississippi region. A student at Louisiana State University, she will call on customers in Baton Rouge, West Baton Rouge, Liv-ingston, and Ascension, Mississippi. Didier, a Certified Dental Assistant, brings 10 years of dental experience to the Benco family.

Tina Fontineas, Territory RepresentativeThe Benco Dental team welcomes Tina Fon-tineas in the Great Lakes region. She attended Walsh College and brings 15 years of experi-ence in the dental industry to the position.

Whitney Freeman, Territory Representative Whitney Freeman joins Benco Dental in the SoCal region. She is a DeVry University graduate and a Registered Dental Assistant.

Jason Hooper, Territory Representative Jason Hooper joins Benco Dental in the Mid South region. Hooper, a University of Memphis graduate, brings more than four years experience to the position. He will call on customers in Memphis and the surrounding areas.

Jeff Jones, Territory Representative The Benco Dental team welcomes Jeff Jones in the Alamo region. He will call on custom-ers in Austin and San Antonio, Texas. Jones, a graduate of the United States Coast Guard Academy, received the United States Coast Guard Commendation Medal.

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Patterson Dental Sales Graduates

Tommy Bruneau Isabel Burnett Susan Capachione Brandon CleverlyKari Clark

Brett Foltz Bruce Forbes Kyle Garner Matt LaneRick Hanson

Drew Loomis Debby Mackery Colin Miller Anthony RandazzoKelly Moonshower

Henry Schein Appointees AnnouncementsGeoff Snyder, Field Sales ConsultantSnyder will represent Henry Schein Dental at its center in Syracuse, N.Y. He has 20 years of experience in the dental industry and was previously employed as a territory representative. Snyder received his B.S. from DePaul University in Chicago, IL.

Nicole Morgan, Field Sales Consultant Morgan will represent Henry Schein Dental at its center in Pittsburgh, PA. She has 11 years of experience in the dental industry and was previously employed as a territory representative. Morgan received her B.S. from Allegheny College in Meadville, PA.

Kevin Swearingen, Field Sales Consultant Swearingen will represent Henry Schein Dental at its center in Orlando, FL. Swearingen received his B.S. from Florida State University in Tallahassee, FL.

Ted Reagan Bill Rodriguez Trish Rodriguez Paul Waters

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