Episode 770: I Did a Digital Scan … Now What?

 Tiff and Dana continue with their series of efficiency hacks. In this episode, they look at digital scanners and x-rays — setting up a standard protocol to ensure quality diagnostics and after-the-fact expectations. You’ll hear the two specifically touch on:

• Incorporate scans into patient conversations

• Establish a protocol for after an x-ray is complete

• Assess whether your team likes the system you’re using

• Track case acceptance and diagnoses

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Transcript:

Tiffanie (00:02.073)

Hello, Dana, welcome back. I am so excited to be here with you. I'm so excited for this month because I feel like this month is dedicated to TIFF even though it's like December and it's cold and it's like, okay, not TIFF's ideal world. And by cold, I mean like 65 degrees because I'm in Phoenix, you know, but it's fine. It's still cold, but it's efficiency hacks. And I know this whole month we've been focusing in on efficiency. And Dana is like...

 

my ride or die girl when it comes to efficiencies and understanding tips like brain and I think we work so similarly in that world Dana that it makes me really excited to do these podcasts with you today because I know you're constantly looking for efficiency to maybe it's a mom thing. I don't know. I like I hate wasted time. It might be a mom thing like as I'm talking out loud, I'm thinking maybe it is especially because I have one and I'm

 

Dana (00:49.03)

Yeah, actually.

 

Tiffanie (00:58.365)

wild all the time I feel like I'm coordinating his life constantly and I have one. So I don't know how you're doing it over there. Plus your farm animals and extra stuff. I love your life. I love thinking about your life. But how excited are you for efficiency hacks? And do you think that's why? Is it a mom thing? What is this?

 

Dana (01:19.37)

Yeah, it might be honestly, I think this is my month because I am like you if I have to spend one second longer doing something like I'm angry about that one second that I spent that could have been faster that feels wasted.

 

Tiffanie (01:33.429)

Yeah, yeah, I could have been doing something else or breathing like I could have just been breathing for a little bit longer. I Love it. I love it. I love it. I love it. Okay, good. So we're on the same page So Dana is an excellent mother you guys just so you know, and she coordinates a lot of lives in her household I coordinate too, and I think I'm pretty decent at it, but Dana is freaking amazing So if you ever need life hacks, honestly, truly you need life hacks. You need workout hacks. You need some cute

 

Dana (01:40.205)

Yep, agreed.

 

Tiffanie (02:03.169)

freaking leggings, you need some new running shoes, you need some protein bars, you need help with your kids' schedules. Dana is your girl. This woman knows it all. If you're not working with her yet and you're like, you know what, I need a little dental, but I also need a little life, Dana is your girl. This woman has it on lockdown. Tip Tuesday, maybe you should just, maybe that should be the new Instagram thing is that it's like Dana's Tip Tuesday because these freaking protein bars I'm still obsessed with. Thank you.

 

Dana (02:20.842)

I'm sorry.

 

Dana (02:33.138)

Good.

 

Tiffanie (02:33.145)

Built bars if anybody needs to know I know we don't have an affiliate link Maybe that's the next thing we work on which start we start affiliated with protein companies I think today would be smart I've had a lot of practices It's towards the end of the year ready obviously in and the last quarter of the year a lot of practices are like purchasing power Right, like what can we do? They're talking to their financial advisors and their CPAs. They're like, what do we do for tax breaks? Like

 

Dana (02:39.458)

We should.

 

Tiffanie (02:59.729)

what do I what's left what do I need to handle so I have a lot of practices coming at me um for the mill machines obviously right we talked about that before but also like digital scanners um and then I throw in their digital x-rays as well which I know Dana and I talked about this I had a time like I know most of you if not all of you I hope are I don't even know if they still make the like concoction you know the liquids that smells so bad like I don't I think we're all

 

Dana (03:24.619)

Yeah.

 

Tiffanie (03:27.377)

doomed for that. I don't think any of us should have been inhaling whatever was in that stuff. But to mix and do those x-rays by hand, I don't think anybody's really doing that anymore. I don't think they still make the materials for it. They shouldn't be. If they are, digital x-rays need to happen. So we talked about that before. And I think as much as I was like, everybody's doing digital x-rays. I think it is smart to talk about the digital x-rays when we talk about digital scans because...

 

Dana brought up a really good point. And Dana, if you want to speak on this part, like the standards and protocols and the quality of the x-rays, and I know, as a hygienist, right by trade, that was really big for you, because you were taking a lot of freaking x-rays, but you're helping your co diagnosing with your doctor more than the dental assistant side is. So you I think you could speak on the standards and protocols and making sure if you're doing when you're doing digital x-rays, do you have those things done? And Dana, what are some things that you look for helping practices now even to make sure that those are clear?

 

Dana (04:21.034)

Yeah. And I think I never ever just like warning right on this. I never ever want to expose the patient to unnecessary radiation, right? For sure. So it's not like go in there and just duplicate and reduplicate x-rays. But I think digital x-rays give you a gateway to kind of set protocols because if we have to retake an x-ray, it's not nearly as difficult or time consuming to get diagnostic or good quality x-rays. And so I think digital kind of gives some leeway there for that.

 

Tiffanie (04:29.113)

for sure.

 

Dana (04:50.966)

So I think the important thing is, is setting up x-ray standard protocols, right? If you are taking a periapical, what has to be present for each tooth, right? Like what do we need to see on that to make it diagnostic quality? One, because we really wanna make sure we can diagnose the things that.

 

Tiffanie (04:51.129)

for sure.

 

Dana (05:08.422)

are affecting our patients. And then two, if we are referring out, if we are sending these things anywhere, if we're using them for insurance, right? All the purposes that you use x-rays for, they really need to be diagnostic quality. So I think, think about all the x-rays that you take in your practice. Think about the standards for each tooth or each position of that x-ray, what should be there? And then again, it's kind of calibrating your team on that, right? Tracking that and making sure that each x-ray that we are taking really is of diagnostic quality. If not,

 

We need to take it again, right? We need to ensure that we are practicing those protocols and those standards that we set.

 

Tiffanie (05:43.177)

Yeah, I love that. I love that you prefaced it with the radiation piece, right? And digital X-rays, we all know, have a very limited amount of radiation, but exposure is exposure, and the world is the world. So we're not gonna fight and argue that, but I do think it is important to know if we don't have these standards and protocols in place, we don't know what a good X-ray is, or we're not retaking them when we know that they're not good quality. Not only like...

 

I think you have a choice then, right? You have a choice of like this limited radiation or the potential to misdiagnose something. And I think, right, if you can't see an apathy of a tooth on a PA, that's a problem because I have surely seen, you know, on a tooth that isn't hurting, on a mouth that's never had a cavity, like I've seen lesions on, my doctor has found them.

 

And so it's like, if you're not getting those, and when I was a young dental assistant, I did not get that. I'm like, the tooth, you're working on the tooth, you're doing the crown on the tooth, what are you talking about, right? And retaking the x-rays back then was, I waiting for it to come through the stupid machine, right? But then as soon as we got those digital x-rays, I was like, okay, I can do this, but we had to have the standards and protocols in place. So I think that's something that the doctors really need to get clear on themselves.

 

And then doctors, you have to get clear on it yourself, and then you have to figure out how you're gonna hold the accountability piece, right? Because if you walk in three times out of five of an X-ray that doesn't have the apathy, three times you're like, whatever, we'll deal with it, I'm tired of saying it. But two times you're like, please retake. They don't understand. They're like, okay, sometimes he wants a new one, sometimes he doesn't. I'm just gonna wait to see when he comes in what he says.

 

That's not a standard or protocol. That's a like, I don't know, roll of the dice. I don't know what to call that, right? So I think that's huge with digital X-rays. If you don't have a way to win, you don't have the knowledge base to know, it makes it really difficult. So digital X-rays, make sure you've got those systems and protocols put into place. And then something I thought of is not all digital X-ray sensors or phosphate.

 

Tiffanie (08:00.437)

Oh my gosh, I blanked. Phosphate pieces, whatever they are, right? Plates, they're not all the same. They're not all made the same and they don't all produce the same result. So when you're looking at your digital x-rays, this is today's your reminder, do yourself a Christmas favor and make sure that your x-rays are the quality that you want them to be, not just by the person who took the x-ray, but by the machine that's taking the x-ray. So if they're coming out blurry, I've seen some real...

 

like grainy x-rays that were the sensor was the issue, not the software program and not the person taking the x-ray, it was the sensor. Sometimes those cords get, you know, they get moved around a lot, they get wrapped around. I know don't wrap them around, right? We used to do that in the beginning. We'd take the sensor and we'd wrap them around and then it just pulls.

 

the cord out of the sensor so they get broken. So watch for those things. And when they need to be replaced, replace them. And if you're not happy with the quality of the digital sensors or phosphate plates that you have now, look for a different brand. Because again, not all brands are alike. Just say we've mentioned the protein powder, like not all protein powder is the same, right? Some of it tastes really great. Some of it tastes like chalk. Some of it's, you know.

 

whey protein, some of it's pea protein, like it's the same and we forget that. We think, well, it's just a digital sensor. It should work the same and it just doesn't. So I would make sure that you like the results that you're getting. If you're following the systems and protocols and you're like, this still isn't a good X-ray, then let's look at the plate or the sensor that you're using. And then Dana, like CBCTs are the same thing, right? Like they're fantastic. And if you're using them, you're using them right.

 

then more power to you. But still, if you're not getting the result that you want, look at your systems and protocols. Look at your brand. Make sure that you're getting what you want out of the program that you're using. And then also, guys, if you're using a CBCT or a Pano, make sure you know how to manipulate it. I am one that I look at that sucker, and I'm just like, there are way too many options, way too many buttons here. And I get overwhelmed. So make sure you know how to use it. And make sure that the team that's using it

 

Tiffanie (10:09.161)

knows how to use it because I was that team member that's like, fake it till you make it. It looks great doc, like sure. And I'm like, I don't know how to slice this. Yeah. slice this and tell you if you can do a root canal. I have no idea. So like, if we're manipulating it, make sure that those people those team members are getting the training and they actually know how to do it. And then one thing that a lot of people miss is actually forcing them to show you right because if you had asked me at that point, like I never had to do that. I was like the

 

Dana (10:16.098)

There's a food pro.

 

Tiffanie (10:37.473)

the front office, back office, back and forth. And I'm like, just do your thing, doc, just do your thing. But if he had asked me like, hey, slice that and show me, I'd be like, yeah, no, walk me through that, right? But we don't always ask everybody to like show me. So show and tell. And then Dana scans, that's huge. And I think it's been huge. I don't know, the last six months, there's been this incredible spike and these things have been around forever.

 

But within the last six months to a year, it's just been this incredible spike of usage and purchasing and purchase power. And I swear if one more of my doctors is like, should I buy a scanner? I'm like, I don't know. What are you going to use it for? Right? Like everybody should have a scanner. Yes, just buy a scanner. So what are you seeing your practices use the scanners for? And when you're working with them and you're helping them with like increasing their diagnosis and their case acceptance and all of these pieces, how are you integrating?

 

Dana (11:17.105)

Yeah. Very good. Thank you.

 

Tiffanie (11:31.329)

the scanner into those conversations.

 

Dana (11:34.282)

Yeah, I think really skinners initially were thought of for ortho, right? Or they were initially purchased to like remove typical impressions. And well, yeah, they are so much more easy to use, so much more patient friendly to not have that goop like running down your throat. Yeah. Or in your hair all over your face, you know, really I think we're starting to see that it isn't just for that, that it is a huge diagnosis tool.

 

Tiffanie (11:39.074)

Yeah.

 

Tiffanie (11:51.62)

Get in your hair.

 

Dana (12:03.53)

So I think when I start to incorporate it, I'm like, okay, let's make sure every new patient, we've got one on every new patient, and then we do a baseline scan every year. Because if we're going to use it as a diagnostic tool, the greatest thing we can show patients is, hey, what happens if we don't do that treatment? Right? We want it to be a diagnosis tool to help increase case acceptance. And then really we want to use that time-lapse feature to say, hey, because we didn't opt to do this treatment, this is where it's getting worse or where we're seeing some more signs and symptoms.

 

Tiffanie (12:12.139)

You're welcome.

 

Dana (12:32.066)

So I think first and foremost, every new patient, let's get baseline scans on them. And then any re-care patient, let's do it yearly.

 

Tiffanie (12:39.225)

I love that. Yeah, that's really smart. And I think you're right, it was for ortho, right? And it's so useful for ortho, especially when you do that time lapse, because we all know our teeth are constantly moving. And if you had ortho before, you're not wearing your retainers, you got, you know, the muscle memory, like, it'll just go back all those pieces. So it's really cool to be able to show patients who think that everything's fine, that how much their teeth are changing over time.

 

So I do love that. And I know a lot of practices are integrating it into the new patients. I do work closely with a lot of hygiene teams because that's where it's coming in, right? It's coming into the hygiene world typically unless you're doing your new patient consults on doctor's side, then it's your dental assistants, but guess who's getting the re-care one? It's still your hygiene team. So if you're not training your hygiene team and working with them on getting really good at these.

 

We like to call them scan parties. Have some scan parties, scan some nouns, just run through it, time yourselves, get really good. If you're not doing that, you're doing yourself a disfavor, and I think that you're probably not paying off your scanner. So let's get that scanner paid for. That's my number one rule to all of my practices when they say, can I buy this? I'm like, absolutely, but how is it going to pay for itself?

 

Dana (13:45.643)

I'm sorry.

 

Tiffanie (13:54.037)

because I don't want that money coming out of your pocket. I want that money to, I want it to be an investment that pays for itself. So how are we going to do that? Scams, you guys, I think that was brilliant. All new patients, and then always like that next, that one year re-care, right? So I usually tell my hygiene team, alternate with your x-rays. So whatever, however you need to get on that routine, from new patient start,

 

get on that routine where every other is either x-rays or a scan because we're not trying to add time, right? We're not trying to make things difficult, but if you're trying to do everything in one appointment, so I've seen hygiene that's got a re-care that's got four bite wings, two PAs, a scan, and periochard, then I'm like, okay, yeah, so you're coming to me saying I don't have time to clean, I don't have time for an exam, well, how about we

 

we have to see it. How about we do four bite wings and two PAs and then next time we do a scan and a period chart? How about we split the odds and take that same 15-minute bundle at the beginning of your appointment so that you then have the 45 minutes to clean an exam on your re-cares? Now, Dana...

 

in being in hygiene yourself, I can always rely on this and put you in that corner. Thank you. My dental assistant side is like, you can do anything you want. So I like to pick the hygiene brain. How does that work for you and for your teams? Like how have you seen that work with practices and hygienists to really get those things integrated into those recare appointments?

 

Dana (15:30.314)

And I agree with you. I think it is doing those scanning parties, getting them really comfortable with scanning because ideally in a hygiene visit, you can get a scan under five minutes, right? Which if you did your x-rays or like that's usually the amount of time you allot for those x-rays. So it is kind of the same, right? So making sure that you're really comfortable. Just tip as a hygienist, if you're struggling with scan, scan yourself over and over again, because it's usually the orientation in the mouth to the screen that we struggle with.

 

Tiffanie (15:38.142)

For sure.

 

Tiffanie (15:55.629)

Mm.

 

Dana (15:55.978)

I feel like our analytical brains as hygienists are like, nah, I can't quite get that. So scanning's help over and over again. And then I think it is, we never wanna cram it all in, like you said, if you're doing x-rays and you're doing periodontics and you're scanning, the way or the place that scanning helps with case acceptance or diagnosis is actually talking about the scans and reviewing them with patients. So if we are only leaving ourselves enough time to scan, then we probably aren't pulling it up, showing the patient, right?

 

Tiffanie (15:59.114)

Yeah.

 

Tiffanie (16:18.294)

Mm-hmm.

 

Dana (16:25.354)

It's a diagnostic tool, just like holding a mirror, holding your mirror, and then saying, hold your breath and don't breathe, see that spot right there, right? We don't have to do that anymore. We've got these scanners, right? Or at least in your photos, right? But I feel like the great thing about them is you literally can take your fingers and turn and manipulate and show patients every single angle. So it is less likely for a patient to be able to say, oh, there's not a problem there.

 

Tiffanie (16:32.693)

Yeah. That's so true. Yeah.

 

Tiffanie (16:47.481)

Yeah.

 

Dana (16:53.738)

Right? Like patients can ignore the things that they see. And when they can visually see them, that is where you get your increase in case acceptance from this. So, yes, I want you to do the scanning, but I also want you to make sure that you're talking about the scan, reviewing any of your findings, manipulating those teeth and letting them see it from every angle, because the less that they can tell themselves, there's really nothing there. And I don't need to get that fixed. Right. There's where that barrier for case acceptance is.

 

Tiffanie (16:54.189)

Yeah.

 

Tiffanie (17:07.127)

Yeah.

 

Tiffanie (17:19.869)

Oh my gosh, that's so smart. So as you're saying that, I'm like, well, that's a system and a protocol. So systems and protocols for both, right? Making sure with digital x-rays and digital scans that you have those protocols in place and the expectations. So most of the time I'm seeing practices purchase the digital scans and the hygienists think they're for the dental assistants, right? And the dental assistants think that they're just for scanning for impressions. And then doctors are upset because they're not getting used properly. And it's like, okay, well.

 

Did we have the conversation of what our expectation is? What's the frequency? What's the system? What do you do with it afterwards? Dana, I think that was huge because I think that is something that's missed. It's like a check mark. Well, I did the scan, but what did we do with the scan? Why are we taking the scans if we're not doing something with it? So I love that. So I think that rolls into our action items. Like I think number one, first and foremost, make sure for digital scans, digital x-rays, you have.

 

systems and protocols built with expectations for the actual doing of it, but then what do you do with it thereafter? So have both of those pieces in your systems and your protocols. Start with new patients, right? Start with new patients, get that busted out for those scans, and then have that protocol thereafter every year or so getting those done. And then you guys check your systems. Do you like the system that you have, meaning the frequency that you're doing it, but then also do you like

 

the system, like the actual program that you're using, are you getting the results from the program you've invested in that you require? Ways to know that one, are you happy with the picture? Number one, are you happy with this freaking picture? Is there anything that we could have done differently to have gotten a better picture? Or is this just bottom line, this is what it looks like? Are you happy with it? You got to make that decision yourself. Secondary, so that would be to start really tracking your case acceptance and your diagnosis.

 

This is huge because there are so many tools out there to help you with your diagnosis. Your brains are busy. You're all over the place. And sometimes we don't know how to make that decision, right? I can't believe, I can imagine having the job of a dentist, having to make that decision for someone, like is this treatable? Is this not treatable? Do we need to do something? Do we not? That's so stressful. So we have so many tools out there that help us determine that. And then like Dana said, pulling those things up for the patients to see them, the patients get to help make that decision too.

 

Tiffanie (19:41.469)

you show me some nasty color in my tooth and I'm like fix that. Get that out of my mouth. So whether you thought it was decay or you thought it was stain or you thought it needed to be fixed or not, now the patient's helping you diagnose. So get those systems and protocols in place, get those expectations, utilize the systems correctly, and make sure you have the ones that you want, that you're happy with the results, whether it's our results or the actual system's results, figure out which one, figure out what you want it to look like and if you're getting that.

 

And then track, I say my last one is make sure you're tracking your case acceptance and your diagnosis because again, you wanna make sure anything you're doing is paying for itself and you wanna see that increase. Both of those things should increase as you're doing these digital pieces the right way. Dana, is there anything you feel like we missed on those action items?

 

Dana (20:30.462)

No, I think that sums it up great.

 

Tiffanie (20:33.253)

Awesome. Okay. Well, thank you, Dana, for being here. You had a ton of tips. I knew you would, especially on those freaking scanners and that ding, that ding, ding hygiene room. Like it's so, it's so much. I love the tip and I'm going to use this for my clients because we talk to clients all the time about this. I love the tip of scanning on yourself because you're right. It is that like orientation piece and it can get really confusing. So I love that. I'm going to keep using that. Thank you. Thanks for being here today.

 

And you guys, if you need tips and tricks, or if you need someone to come in and be like, let me help you make this more simple. Sometimes that third party perspective can really do the trick. Sometimes we see things that we're like, did you know that you're actually, if you just turn to the left like a smidgen, you'd get a totally different result. And I know it looks simple and it seems simple, but when you're doing it every day, you don't see them. And you guys, that's what we're here for. We do it constantly for clients. We do it for people who are not clients that just email in and have questions like,

 

We're here to help you. We want to help you and that's what we do every single day. So if you need something, if you've got questions, you want more help with this situation or a different one, please don't hesitate to reach out at hello at the dental 18.com. We are so happy to help you. Dana, thank you for being here. Thanks for all the tips. I have a time to take away to my clients and I hope you have a great rest of your day.

 

Dana (21:50.722)

Thanks for having me, it's always fun, you too.

 

Tiffanie (21:53.165)

Thanks, bye.