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Office Visit: Making Dentistry Fun & Profitable By Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

More by this author (317)

Welcome to the first installment of Office Visit, a new feature in our magazine. We will visit a Townie’s office and profile their equipment, design or unique practice philosophy. If you would like to participate, or nominate a colleague please send me an e-mail at tom@dentaltown.com.

This month we are pleased to take you inside Dr. Brian Schaefer’s office, a short jog from Lambeau Field in Green Bay, Wisc. Dr. Schaefer has embraced technology in his practice to improve efficiency and personal satisfaction.

Name: Brian P. Schaefer, DDS
Practice Location: Green Bay, Wisc. – Near Lambeau Field
Graduate from: Marquette University School of Dentistry
Year graduated from dental school: 1986
Year your practice opened: Associated with practice until 1991 when it was purchased from the senior doctor.

Equipment List

    Computer System:
  • Computers in all ops, front desk, office and consult room 1
    Air Abrasion:
  • Kreativ Mach V Air Abrasion Multi-op unit (discontinued)
    Endodontics
  • SybronEndo Elements obturation unit – www.sybronendo.com 3
  • J. Morita USA Root ZX apex locator – www.jmoritausa.com
  • Brasseler USA EndoSequence Endodontic Handpiece with torque control

Q: When did you decide that having an office filled with high-tech equipment was an important goal?

A: In 1988, I picked up my first apex locator at a convention. Apex locators were still a novelty back then, and not looked upon highly by the endo establishment. However, I found that it made my endodontic treatment more efficient, and improved the quality of my work. It was then that I was hooked on dental technology. Over the years, I’ve found that to be true about most technology that I have brought into the office. Aside from the increases in efficiency and quality, technology has brought a lot of fun into dentistry. The availability of high-tech equipment is one of the best reasons that right now is the golden age of dentistry.

Q: How would a dentist in your community describe your office?

A: We have a bit of a reputation as a high-tech office that acts as a guinea pig for new equipment. I’ve turned my dental friends onto and off of equipment I have used in my office. I may have had an early jump on a lot of high-tech equipment, but as my colleagues have seen how well it has worked in this office, many of them have jumped on the bandwagon also.

Q: Which pieces of equipment have provided the fastest return on your investment? What factors made this possible?

A: Most everything provides an ROI. Some provide it in actual dollar savings or increased production. Others provide it in pure satisfaction.

A complete office computer system running practice management software is the backbone of the high-tech office, and provides the fastest ROI. Outside of computers, I’d have to say that the PerioLase, CEREC 3D, Brasseler EndoSequence system and digital cameras have provided the quickest ROI.

The PerioLase has opened up an entire new area of practice – the treatment of periodontal disease with a protocol that has been demonstrated to provide new attachment. Like most general practices, we have a lot of patients who for one reason or another will not see a periodontist. We now have the ability to treat many of those patients in-house. It has been very well received by patients.

We have eliminated most posterior crowns with the CEREC 3D. This little machine makes the nicest porcelain onlays that you will find anywhere. Patients are more receptive to onlays, I can conserve more tooth structure, rarely do we ever experience the need for endodontics following placement of an onlay and there is no lab fee. It is a real win-win situation.

Digital cameras provide instant patient education and documentation. When a patient sees a quadrant or full-arch image of his/her teeth on the 19 inch monitor, it is so much easier to understand his/her dental issues and treatment. A single tooth IOC image pales in comparison. When a patient understands his/her own problems, s/he accept treatment at a much higher rate.

Rotary endo is all about efficiency. I’ve tried several systems over the years, and have a drawerful of old motors and files to show for it. The Brasseler system has become my favorite.

Q: Please explain why you have three different digital cameras? Do they serve separate purposes, or is this a case of updating equipment?

A: Early on, I saw how digital photography could help a practice. I was determined to find one that would work. We tried the Macro V Polaroid, and various early model Olympus and Sony digital cameras. They worked OK, but nothing to get excited about. The introduction of the Nikon D1 SLR digital camera allowed for high-quality digital dental photography for the first time. We used it for several years before we upgraded to a smaller bodied, higher resolution camera like the D10. The G6 is a smaller camera, which works better in the hands of assistants and hygienists.

Q: Which pieces of equipment are most appreciated by your patients? Why?

A: I found that unless a patient is told the benefits of any piece of equipment, s/he doesn’t really appreciate any of them. The world has gone high tech, and people are inundated with it. They expect to see it everywhere now. So, unless we show patients what we are doing and how it benefits them, there is no appreciation. Communication is so important here.

Believe it or not, the item most commented on are the Skyman Sky-Scapes, which are decorative fluorescent light covers (www.azskyman.com), we installed last year. People LOVE these things. Equipment wise, we get the most comments on our digital radiographs. We use ScanX intraoral and Instrumentarium digital pan. Patients are fascinated by seeing their own radiographs on a large screen.

Q: Select five pieces of equipment from your list and describe the following:

A: 1) Office computer system. Our first system was installed in 1993, and we were one of the first offices to bring the computer into the operatory in our area. We’ve upgraded every four years since. I remember my front-desk person doing claims by hand previous to this. It used to take almost seven days for a claim to leave our office, and the charts were piled high all over the front desk. Procedures were not always posted to the pegboard, and I gave away a lot of dentistry as a result. Compared to today, it was total chaos.

We use Dentrix and have been very happy with how it has worked for us over the past 13 years. The increased efficiency of the computerized office reduces staffing requirements, and increases cash flow. The patient sees the benefits of this, but it is the dental office that enjoys the fruits of computerization.

2) X-rite Shadevision. This was purchased in 2003. I had seen other shade-taking devices, and most were large and cumbersome. The Shadevision unit mapped multiple parts of the tooth, and was the right size for the office. I liked the idea of taking the subjectivity out of shade taking – especially for anterior crowns and composites. Now, it is rare for an anterior crown to be sent back to the lab for shade modification, or to have to redo a Class III or IV restoration when it doesn’t match the tooth. When I tell patients what this device does, they appreciate the extra effort. The lab receives a shade map report showing gingival, body and incisal hue, chroma and value. I also send a high-quality digital image. Given this combination, the lab most always gets the shade right the first time. That makes for a happy dentist and patient.

3) The PerioLase was introduced to the office in December 2005. I had looked at it a year earlier, and read quite a bit about it on Dentaltown. The more I read about it, the more I liked it. We have an effective SRP program in our office, but saw too many patients who needed more than that declining referrals to the periodonist for one reason or another. The PerioLase has an FDA cleared protocol for laser assisted new attachment, which no other laser at this time can offer. I like the idea of being able to treat perio in my office, and patients have been very receptive to the PerioLase.

4) We started with the CEREC 2 back in 1999. It worked fine, but required a lot of mental gymnastics to interpret the graphics. I upgraded to the C3 when it was introduced in 2000. After a hardware and software upgrade, we are now using CEREC 3D. Being a tech guy, I was mesmerized by the demo. I was determined to make this work for my office. There are a lot of situations where I will find a tooth in need of restoration, not bad enough where I feel that an aggressive crown preparation is warranted, yet worse off than what could simply be filled. There are a lot of these gray-area teeth in our charts. These teeth are perfect candidates for onlays and the CEREC. I do have a stain and glaze oven in our lab, and use it for all CEREC crowns and some onlays. I just find that I don’t end up doing as many posterior crowns anymore.

We don’t market the CEREC, other than to explain the benefits of the one-visit onlay verses the crown. Tooth conservation is the hot button with most patients. Anyone who has ever had to wear a temporary crown for some time is eager to get his/her dental work done in one visit.

The annual software upgrades make the current CEREC light years ahead of where I started out in 1999. Points of light have been replaced by a high-resolution 3D image of the restoration that is created and modified right on the screen. It is an incredible technology that I would be hard pressed to ever to give up. I don’t know who is more impressed with it, my patients or me.

5) We entered the digital radiograph era in 1998 with direct sensors. For one reason or another, hard sensors never caught on in our office. We needed to keep the processor for our pan, so it was too easy to go back to film. In 2003, still wanting to be digital, I purchased the ScanX PSP system. It was the best of both worlds; we could go digital with our radiographs, and still have the comfort level of film type placement techniques. The staff caught on immediately, and we have loved the simplicity, cost (no annual warranty) and quality of our images.

I had difficulty getting an adequate PSP pan, so we purchased the Instrumentarium digital panoramic machine six months later. This replaced the film-based Gendex pan which had been the office workhorse for years. The digital image; however, was quite an improvement over film.

I still have the direct sensor for occasional use, but we have let the warranty lapse.

No patient likes having radiographs taken, but patients are very impressed by what they see on the computer monitor.

Q: What is your philosophy regarding office technology? Do you enjoy the latest and greatest, does it attract new patients, make life easier, etc.? What misconceptions do your colleagues have about technology?

A: My philosophy regarding technology is simple. I like technology that makes dentistry more fun.

There are a lot of ways to do most procedures in a dental office, but I like to invest in technology that will do it more efficiently, increase quality of treatment and make dentistry more enjoyable for the patient and me.

The biggest misconception my colleagues have about technology is the cost. I’ve gotten over the fact that dental equipment manufacturers see us as an open checkbook. Get over it. If you wait until the price comes down on most technology, then you will be in for a letdown on your retirement day. It just doesn’t happen.

Q: Is it difficult to incorporate new technology into your daily routine? What is your approach to integrating new technology into your practice?

A: Years ago, I made the mistake of bringing too much technology into the office at once. Information overload will overwhelm the entire office, and effectively cause most equipment to be shelved. Everything needs to be built up from a solid foundation. Build slowly, but build on previously integrated technology. I’ve learned to accept a learning curve on everything, and that everything is made to be broken.

All the technology I have added to the office has been done over a period of several years. That is the most fiscally and emotionally reasonable manner in which to do it. Large ticket items are added when it makes financial sense to do so. It is much easier to add technology when your practice is more mature, so practice owners need to look at their finances and be responsible to their family first. I can afford equipment now that would have broken me 10 years ago, so it is up to each dentist to know his or her finances.

Q: How do you address staff training each time you add a new piece of technology? Do you take them to training, do a lunch and learn, use local sales rep from the company, etc.?

A: Most high-tech purchases will include training in your office. Even with that, I have found that staff tends to need repetition to perfect anything. Staff needs to be thrown into the fire immediately, but observed and supported. Don’t make it easy to slide back to old techniques. Once again, this is where the dentist needs to be the leader and most knowledgeable about every piece of equipment in the office.

Q: Which items from your list were purchased as a result of a recommendation on Dentaltown.com?

A: Dentaltown has been a great resource for equipment ideas and research. I have learned to do my due diligence to avoid being on the bleeding edge, and Dentaltown is one of the best sites to learn about most any dental technology. A lot of dentists who are not familiar with Dentaltown also are not as familiar with quite a lot of technology available to them. Over the past several years, I can thank Dentaltown for introducing me to the Isolite, ScanX, PerioLase, Waterlase MD, DIAGNOdent, KaVo electric handpieces and various disposable products.

Q: If your best friend from dental school called for a technology recommendation, which items would you insist that s/he purchase first? Why?

A: No question it would be to computerize his/her entire office, and don’t go cheap here. Hire a dental computer guru who knows what s/he is doing and has done it many times before. This is the backbone to everything that you are going to be adding later. Once that is done, I’d like to see a high-end practice management software installed. Then, I would add a great digital SLR camera setup like the Canon D30. From there, build up slowly and add technology as desired. Personally, I would go with a PerioLase to develop the perio side of your practice and/or CEREC 3D to develop the onlay side of a practice.

Q: How do you pay for this equipment – loan, lease? Do you have a technology budget each year, or do you evaluate each purchase based on ROI? What do you consider a “no-brainer” purchase? Give an example.

A: I have never leased any equipment. I’ve never seen any advantage to it. A strong banker relationship should be important to every dentist and one of the first business relationships established. This is so important to any dentist’s personal and professional life. Depending on the purchase, I will either pay cash or take a loan and pay it off early. At this time, I don’t have a real budget, but will evaluate a technology based on ROI. I look at some items, like the PerioLase, and see a piece of equipment that has immediate ROI. Some others, like a hard-tissue laser, might not have the immediate ROI impact, as in my office, it is only replacing a procedure previously done with a handpiece.

If you’d like to talk with Dr. Schaefer about his high-tech office, he is often found on the message boards at www.dentaltown.com.

Dentaltown Magazine
September 2025
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