CDEN0310

16 I I clinical report _ imaging We have used Curtis Marketing Group, Sesame CommunicationsandConnecttoPatientsforcreat- ing and optimising our websites (Figs. 1a–e). Patient access to schedule, account information and to paying bills online is provided by Sesame Communications as well. Lighthouse PLZ is another example of web-based solutions that work with your existing practice management software. We usethisapplicationtohandleourre-carereminders (by text, e-mail or regular mail), electronic newslet- ter and our direct mail marketing, and to monitor practice statistics. They also have a smart-phone application to allow you to check patient schedule or history from your phone (Figs. 2a & b). _Initial visit During our initial visit, we review the medical history that the patient filled out on paper, which we scan into their digital chart, or we have them fill it out on a tablet PC, which can be signed directly. We also have signature pads attached to all our administrative workstations. After the den- tisthasmetthepatientandreviewedtheconcerns, we have our assistant gather the necessary photo- graphic and radiographic images. We use a digital camera to take a series of digital photographs, which will serve as documentation of existing conditions and for Invisalign records, if required, for cosmetic imaging or for referral communica- tion (Figs. 3a & b). Depending on the patient’s concerns and exist- ing condition, the radiographic imaging may be an intra-oral set of digital radiographs, a panoramic and bite wing set of digital radiographs, a CBCT (cone-beam computed tomography) scan for im- plantassessmentandtreatmentplanning.Afterac- quiring the radiographic and photographic images, the clinical examination begins with an intra-oral video camera tour of the mouth, which the patient is able to view with the dentist, and examples of problem areas, as well as healthy areas, are shown in this co-discovery or co-diagnostic exercise. The initial examination is in actuality a two-way street where we, as well as the patient, get to know andevaluateeachother.Anythingthatwillfacilitate communication and provide options and solutions for the patient will go a long way towards building atrustingrelationship.Technologyisadouble-sided sword; if it is used to impress or pressure a patient into accepting care, it can become a very negative experience, whereas if it is used as a vehicle to ad- dress their concerns and to help them co-diagnose their condition, the patient will most likely move forward with care. Many practices have also incorporated stand- alone applications, such as VELscope (LED Dental, Inc.) and the Identafi 3000 (Trimira Remicalm), for help in oral-cancer screening by using high-energy lightsourcestovisualisetissuefluorescence.Giving the patient an opportunity to see what we see is a very powerful tool in helping them own their dental condition and allowing us to become their advocate for care. _CBCT CBCT has been available since 2000; the driving force for this technology has been implant therapy. The cost for this technology has come down some- what with the introduction of newer technology cosmeticdentistry 3_2010 Fig. 4a_ProMax 3D (Planmeca): small scan imported into InVivo5. Fig. 4b_MyRay Skyview (Cefla Dental Group): medium scan imported into InVivo5. Fig. 4c_i-CAT (Imaging Sciences International): large scan imported into InVivo5. Fig. 5_XCPT 2-D implant planning and consultative tool. Fig. 4a Fig. 4b Fig. 4c Fig. 5