Effective Assisting

Timothy M. Bizga, DDS, FAGD

www.2thLectures.com

ABOUT ME

Holy Toledo

What makes an Effective Assistant

Type A

Application

Attitude

Where is your skill level?

The Law of the Mirror

• You must see value IN yourself to continue to add value TO yourself

• You will never rise about the level of YOUR SELF IMAGE

Improving your self image

1. Guard your self talk…the most important person you talk to everyday is YOU

2. Add value to others…lose yourself by giving yourself

3. Do the right thing even when it’s the hard thing

4. Everyday…GET A WIN!!!

3 Things Employers Look For

1. Loyalty/ Dependability

2. Positive Attitude

3. Desire to learn new things and keep growing

• Anything that is healthy, keeps growing!

9 things we hate about our employees

1. We hate when you are only nice to us on special days

✓ This stems from a lack of appreciation

✓ 90:10 rule= we only remember the 10% bad

2. We hate when we have to nag for things to get done

3. We hate when you chew gum

✓ This presents a very unprofessional look to patients

4. We hate when you don’t check the floor after cleaning a room

✓Cleanliness matters to patients and a dirty floor means a dirty facility

Nine things we hate about our employees

5. We hate when you do not introduced us to new patients

✓We need to know if we already met the patient

6. We hate when you do not help us get to know the patients

7. We hate when we have to do ALL the talking

✓We need you to EDUCATE the patient too

✓ 75% conversation should be business and 25% social chitchat

✓ You are not just an employee, you are a TEACHER

Nine things we hate about our employees

8. We hate the personal use of cell phones and Internet at the employee’s desk

✓This is a form of TIME EMBEZZLEMENT

9. We hate when you cry

✓Belittling or criticizing in front of a patient IS NEVER RIGHT

✓Using tears as a form of control IS NEVER RIGHT

Patient types

✓ Never Been to a Dentist

✓Acute needs before

FIXES

Patient types

✓ Dental Phobic

✓Motivated by Pain

Patient types

✓ Last Trip about every 2-5

years

✓No Insurance

✓Be aggressive in

treatment….do not

monitor small things

TREAT

Patient types

✓ Regulars

✓ Learn their preferences

✓Cost Conscience

✓Want the Best

✓Missing teeth

✓Basics and Function First

✓Esthetically driven

Budget

• What is the average family budget, for dental expenses, annually?

$0.00 Dollars

Yet they spent…

1.65 Billion

34 Billion

157.5 Billion

What matters to the Patient

• Can I trust you?

• Are you committed to excellence?

• Do you care about me?

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My CORE

• Treat people first, but teeth are a close second

• Seek first to understand rather than be understood

Question

• What are people most likely to remember when they leave your office?

– Your technical explanations?

– How they felt about the experience?

1.Know

2.Like

3.TRUST

Rules of Business and Referrals

Which Impresses People More?

Purpose of DISC

1. To help you better understand YOURSELF

2. To help you better understand OTHERS

3. To help you be MORE PRODUCTIVE and have LESS ANXIETY when dealing with people

4. To treat others as they wish to be treated

• The one who knows this information is the one responsible for using it and applying it!!

Reserved

Outgoing

First Question

1. Am I more Outgoing, or am I more Reserved?

Understanding Yourself …

Everyone is “wired” differently. To understand yourself better, ask yourself these two questions:

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Understanding Yourself... Traits to look for:

Outgoing / Active

Fast - paced

Involved

Energetic

Optimistic

Positive

Enthusiastic

Reserved/ Passive

Slower – paced

Cautious

Concerned

Reluctant

Critical thinking

Discerning

Reserved

Outgoing

Their focus is on talking

things out.

Their focus is on thinking

things through.7

Second Question

2. Am I more Task-oriented or People-Oriented?

Understanding Yourself...

Task-

Oriented

People-

Oriented

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Understanding Yourself … Traits to look for:

Task-Oriented People-Oriented

Form

Function

Programs

Plans

Projects

Process

Relationships

Caring

Sharing

Emotions

Feelings

Friendships

Task-

Oriented

People-

Oriented

Their focus is on getting

things done.

Their focus is on other

people and how they feel.

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Dominant

Demanding

Direct

Determined

Decisive

Doer

Director

Dogmatic

Dreamer

Diligent

Dynamic

Defiant

The D Type OUTGOING

T

A

S

K

12

Percentage of Population:

Examples:

Basic needs:

10%

Donald Trump, Judge Judy, Dr. Phil, Hillary Clinton

Challenge, Choices and Control

D Types Make Good...

Administrators

Athletes

Boxers

Builders

Business Owners

Coaches

Developers

Directors

Drill Instructors

Entrepreneurs

Executives

Fighter Pilots

Foremen

Government Agents

Law Enforcement Officers

Lawyers

Military / Special Forces

Motivators

News Anchors

Private Investigators

Producers

Race Car Drivers

Real Estate Developers

Sales Managers

Supervisors

Truck Drivers

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The I Type OUTGOING

Inspiring

Influencing

Inducing

Impressive

Interesting

Impressionable

Important

Interchangeable

Interested in People

Imaginative

Impulsive

Illogical

P

E

O

P

L

E

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Percentage of Population:

Examples:

Basic needs:

25% - 30%

Oprah Winfrey, Ellen DeGeneres, Dr. Tim Bizga

Recognition, Approval and Popularity

I Types Make Good...

Actors

Airline Attendants

Auctioneers

Broadcasters

Clowns

Coaches

Comedians

Entertainers

Evangelists

Meeting Planners

Peace Corps Volunteers

Performers

Politicians

Preachers

Public Relations Directors

Public Speakers

Masters of Ceremonies

Radio Personalities

Receptionists

Reporters

Salespeople

Teachers

Telemarketers

Telephone Operators

Travel Agents

Wedding Consultants

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The S Type

Supportive

Steady

Stable

Secure

Serve

Sweet

Submissive

Shy

Status Quo

Sentimental

Sameness

Sucker

P

E

O

P

L

E

RESERVED

20

Percentage of Population:

Examples:

Basic needs:

30% – 35%

Dr. Martin Luther King Jr., Paula Abdul, Mother Teresa, Gandhi

Appreciation, Security and Assurance

S Types Make Good...

Artists

Child Care

Workers

Counselors

Customer Service

Representatives

Department Heads

Diplomats

Flight Attendants

Funeral Directors

Human Resource

Directors

Librarians

Managers

Nurses

Painters

Pharmacists

Pastors

Planners

Real Estate Agents

Researchers

School Teachers

Secretaries

Social Workers

Supervisors

Technicians

Veterinarians

Waiters/Waitresses

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The C Type

RESERVED

Cautious

Competent

Cognitive

Careful

Calculating

Critical Thinking

Compliance wanting

Conscientious

Correct

Conformist

Consistent

Cold

T

A

S

K

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Percentage of Population:

Examples:

Basic needs:

20% – 25%

Diane Sawyer, Clint Eastwood, Tiger Woods, Martha Stewart

Quality Answers, Value and Excellence

C Types Make Good...

Accountants

Architects

Artists

Authors

Bankers

Bookkeepers

Composers

Computer Programmers

Consultants

Dentists

Engineers

Finishing Carpenters

Inventors

Lawyers

Librarians

Mechanics

Military Intelligence

Musicians

Philosophers

Photographers

Physicians

Pilots

Professors

Scientists

Surgeons

Teachers

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Meet “Al”

Light Polymerization and Curing Lights

What Plays a Role in Effective Light Curing

Light Curing

Shallow Prep + 10 seconds cure= WORKS

Far from light source, need to cure for additional time. Also pay attention to darker shades…….Light output of 1000+mW is desirable

Light Curing

But here…it’s all about depth

We routinely rest the light source on the cusp, in this case it can be 8-10mm away from the

cervical margin

Halogen Lights

Plasma Arc curing (PAC) lights

Caution: HEAT!Supplying high levels of energy to

the restoration will also deliver energy to the pulp, increasing its

temperature!

This could contribute to pulpitis, post-operative sensitivity and even

require root canal therapy

Light-emitting diode (LED) Curing lights

Curing Issues1. There is no perfect way to test if composite is properly

cured

– To you and me this means you can never OVER CURE

2. Curing light intensity decreases up to 68% between 2-9mm from the target

– To you an me this mean we need to get the light as close to the material as possible, especially in those class II boxes, also add incrementally

3. Light intensity falls off dramatically from the center to the edges, forming a BULLET-SHAPE curing pattern

– To you an me this means we need to move the curing light around larger restoration and cure from different

angles and sides

Beam Collimation and Performance Over Distance

Collimated Not Collimated

Collimated Not Collimated

Beam Collimation and Performance Over Distance

Beam Profile

The effective part of the light beam should be evenly distributed across the face of the light tip

to maximize curing effectiveness

Most lights only deliver 35% of stated output to bottom of deep box

©BlueLight Analytics Inc., 2012

Effect of Light Angle on Curing

undercured

Curing Light Tip

Intraoral Access

8.5 cm

– Low head profile

– Long Rotatable tip

– Ease of maintaining proper angle

SmartLite® Focus provides Excellent Intraoral Access

Light energy delivered lessens as distance of the material from the light tip increases

Light Performance over Distance

2mm

6mm

200

300

400

500

600

700

800

900

7mm 8mm 9mm 10mm

Ou

tpu

t (m

W/c

m2 )

Irradiance Over Distance 7-10mm

SmartLite Focus

Radii

Bluephase Style

Demi Plus

Valo (Std Mode)

Elipar S10

SmartLite® Focus loses LESS energy over distance, making it more effective at delivering energy at clinically relevant

distances than many major competitors

• Collimated beam – Performance over distance

• Wide Spread/Uniform Beam Profile

• Simple Controls – One Button/Rotating Head

• Long Lasting Battery

Shade Analysis and Communication

SHADE TAKING FACTS

1. 60% of remakes are blamed on poor color match

2. It takes 5 new crown cases to cover the cost of

one remake

3. Improper color selection causes great frustration

for the doctor, the laboratory and the patient,

losing time and money for the dentist and

laboratory.

Principles of Light

Shade Selection

CLINICAL TIP:

Determine the Shades Needed for the

Restoration Prior to Tooth Preparation

Shade Selection

• A Desiccated Tooth Will

Appear Lighter than Normal

• Select the Dentin Shade By

Examining the Dentin

What is necessary to see color?

• Light

• Object to interact with the light energy

Limitations

x

x

What Color is This?

X

1. MOST CRUCIAL component for shade taking in Dentistry in VALUE

2. Second most crucial component for shade taking is TRANSLUCENCY

3. Third most crucial component for shade taking is CHROMA

4. LEAST CRUCIAL component for shade taking is HUE

Dental Shade Guides

VITA Classical Shade guide

RULES FOR TAKING shade1. Patient sitting UPRIGHT at an EYE-EYE conversation distance

2. WELL-ILLUMINATED area preferably with color-corrected lighting or Ott-Lites® (sold at Office-Max or Target) held 2 feet from patient

3. Take the shade before you start the procedure

4. Match VALUE first, then CHROMA, then HUE keeping in mind TRANSLUCENCY and its important for anteriors

5. Take a PHOTO

– Be sure to place the shade tab IN THE SAME PLANE as the teeth, incisal edge to incisal edge

6. Recharge your RODS and CONES by looking at an Neutral Gray or Light Blue

7. Lightly wet the teeth and the shade tabs with a clear liquid glaze prior to evaluation

Rite Lite 2 ™ Tri-Spectra LED Shade Matching Light

Alginate

Tray Selection

“The Journey of a Thousand Miles Begins with a Single Step” -Lao-tzu

Fixed Prosthodontic Landscape

• An average office performs 256 single unit crowns per year

• 256 x 150,000 general dentists = 38 million single unit crown procedures per year!

Function of Temps

• Maintain static contacts

• Calm state

• Maintain occlusion

• Trial OVD

Features of Provision Materials

1. Polymerization Choice

– Dual v. Auto

2. Air-inhibited layer

3. Fluorescence

4. Flaking when trimming

– Margin design

5. Fracture Strength

– Clearance

6. BPA free

Selecting the Provisional Material

• Methacrylates

– (poly) methyl

– (poly) ethyl

– Vinyl methyl

– Ethyl methyl

• Composites

– BIS-Acryl

– BIS-GMA Resins

– UDMA

Light Curing the Provisional

• Let the material set for 90 seconds in the mouth then remove and command set with 20 seconds of light curing

Types of Provisional Cements

• Resin-Based – containing di-urethane di-methacrylate

• TNE (Temrex)

• Tempbond Clear (Kerr)

• Zinc Oxide Eugenol• TempBond (Kerr)

• Zinc Oxide NonEugenol• Temp Grip (Dentsply)

• Polycarboxylate• Durelon (3M ESPE)

Value Added Clinical Benefits

The amount of money it can cost a practice when a patient has to return to have the

provisional re-cemented (in lost production, time, materials)

Integrity Temp Grip Technique Tips

• Bleed the syringe twice!

Integrity Temp Grip Technique Tips

• Do not desiccate the tooth before seating!

• Moist cementation reduces opportunity for sensitivity

• Barrier results in the cement staying on the provisional and not on the tooth

Formula for SensitivityStart with trauma and then

desiccate

Efficiency is Key

www.dryshield.com/drtim

Dental Photography

Science and Passion…

Aperture - Diaphragm

Lens Diaphragm

Practical Use of DOF…

Aperture - F/Stop

Tip:

Higher F/Stop – Higher Depth of Field

(Although Aperture is Smaller)

Depth of Field and Aperture

DOF essentials:

• Smaller Aperture – Greater DOF

• Greater Distance to subject – Greater DOF

• Greater the Focal Length – Greater DOF

ISO is Film Sensibility

Typical Macro Flashes

Sigma EM-140 DG Macro Flash

White Balance

White Balance

Magnification 1:4 1:3 1:2 1:1F-Stop 18 28 32 32

Shutter Speed 1/200 s

Histogram Always on

ISO 300

Flash TTL M1/16

WB Flash or Cloud

Lens 60 mm Macro Lens or more

What do I mean…

Basic Photography Essentials

www.photomed.net www.practicon.com www.smartpractice.com

Be Consistent in Your Photography!

• Set the camera magnification and leave it there!

• Keep the same angle for each progressive shot!

• Do not alter f-stops, shutter speeds or flash settings!

• With operatory light…or without?

Smile Retracted Teeth ApartRetracted Teeth

Together

Full Face

Mandible OcclusalMaxillary Occlusal

Protection

Question

• Who are you going to be in 5 years?

– Answer: Very much the same you EXCEPT 3 things…

• Books you read

• People you meet

• Thoughts you tolerate in your mind

The Keys to Your Success Beyond Today

1. Believe while others are doubting2. Plan while others are playing3. Study while others are sleeping4. Decide while others are delaying5. Prepare while others are day-dreaming6. Begin while others are procrastinating7. Work while others are wishing8. Save while others are wasting9. Listen while others are talking10. Smile while others are frowning11. Commend while others are criticizing12. Persist while others are quitting

Contact Info

• Dr. Tim Bizga• Like Dr. Tim Bizga on Facebook

• @DrTimBizga

• 2thLectures.com

• Email: 2thLectures@gmail.com

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