I’m often asked by new and seasoned CEREC users how to decrease their appointment times for a simple crown procedure. This question has a number of different solutions depending on the individual office, but let me offer a couple of helpful hints that may guide you to shorter, more efficient appointments.
1. Follow the 30-30-30 rule
By this I mean set a goal for an hour and a half appointment and break it up into 30 minute segments. The first 30 minutes consists of seating the patient, anesthetizing, prepping the tooth, imaging, designing and sending to the mill. The second 30 minutes will be the milling time, crystallizing and glazing (if e.max) and cooling. The last 30 minutes will be preparing the restoration for bonding, final bonding and cleanup, and releasing the patient. For some offices, this may be 30-40-20. Whatever your situation is, set goals for the appointment. If you are not achieving them, you may find it helpful to time each aspect of the CEREC procedure to identify the efficiency bottleneck.
2. Train your staff
I’ve always been an advocate that nothing creates better efficiency than empowering your staff with procedures that give them value in the final restorations. There are many different areas within the CEREC appointment where this can occur. You can have your assistants do some of the imaging while the patient is numbing up. This even becomes more applicable with the new Omnicam and the cut tool. You can train your staff to do the designing of the restoration, milling the restoration, staining and glazing the restoration and preparing it for bonding: all things that allow you as the dentist to be efficient treating other patients or doing hygiene exams.
3. Hygiene checks
One of the more common bottlenecks I see is a dentist leaving an undesigned restoration to go and do a hygiene exam. Exams can often be unpredictable because you never quite know what you are walking into. Time can range anywhere from 3 to 20 minutes depending on what the immediate concerns of that patient may be. I would recommend to never leave your treatment room until that restoration is milling. That may mean having an assistant complete the design or taking an extra 5 minutes to do it yourself prior to the hygiene check. One strategy that I often use is making great utilization of that “middle 30 minutes” described in point #1. Do the exam when you have free time. Very often this is me stepping into the hygiene room before the cleaning is completed.
Of course nothing can replace training. Having a thorough understanding of your CEREC machine will be the ultimate weapon against fighting efficiency problems. I encourage all owners to pursue continuing education. It will make your CAD/CAM experience more enjoyable for you … and of course your staff!