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Lessons Learned by Dr. Kyle Fagala

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Dentaltown Magazine

Five useful tools for the busy orthodontist

by Dr. Kyle Fagala

Like many of my peers, I began my practice eager to care for patients, run a business and tackle the challenges of the modern orthodontist. Six years later, I’m fortunate to have a successful and fun practice that affords me time to pursue outside interests and hobbies with my growing family. Along the way, I’ve picked up a few tips to improve efficiency in the day-to-day practice of orthodontics—little things I wish I’d known when I was starting out.

Every day presents a new opportunity to enhance office culture and practice success, and sometimes the seemingly small things make the biggest differences in terms of streamlining and improving patient outcomes, optimizing clinical care and maximizing practice efficiency. The following Top 5 list highlights a few of the tips I rely on every day. These steps help my practice run more smoothly, and effectively simplify and expedite the delivery of orthodontic care to my patients.

A checklist for saving time and simplifying your orthodontic practice

1. Loupes and wireless lights. Though not always emphasized in dental school and residency, magnification loupes are a great tool, and I simply wouldn’t want to work without them. I discovered how helpful they are about two years into practice, and since then, Orascoptic HDL 2.5 Macro through-the-lens loupes are a constant fixture on my safety glasses.

After using the loupes for several months and loving the results, I decided to integrate the Spark cordless headlight as well. I can see details of the mouth so much better than I did before taking the leap, and it has made a significant difference in my daily practice. Bracket positioning and composite removal are more easily accomplished, and I suffer far less neck and back pain than I did before integrating these into my daily routine.

Although the light is not necessary for every patient, I rely on it for bonding and debonding procedures in particular. It also includes an orange curing filter to prevent the glue from setting prematurely during bonding. With improved vision, I feel more confident in my bracket placement decisions and, as a result, I can work faster. Additionally, the “tunnel vision” effect with the loupes helps me to focus, and there’s less guesswork involved when working in the darker areas of the mouth. (There are plenty of great companies who produce dental loupes, but I prefer the lightweight Oakley frames that Orascoptic offers.)

2. Diamond discs for IPR. Interproximal reduction has a range of indications, and for many orthodontists who, like me, routinely prescribe clear aligners, it has become an indispensable component of successful treatment. Looking back to residency, most of us learned the IPR technique using hand-applied diamond strips. Although this method is safe and quite effective when learning the procedure, it can be time-consuming, especially when multiple contacts must be adjusted. After experimenting with a variety of IPR methods, I found diamond-coated rotary discs to be the best option for my purposes, offering me a quick, painless and effective method for achieving the desired results.

I regularly perform IPR in my practice and use the Komet DISCtance IPR system at least four or five times per day to correct tooth-size discrepancies, eliminate crowding or lengthen contacts to eliminate black triangles. The discs work with my slow-speed handpiece, and I can remove the required amount of enamel precisely, rapidly and with no pain for the patient. These perforated rotary discs offer the fastest, most precise option for my busy practice, where it is imperative that I perform IPR quickly, consistently and safely. Keep in mind that a safety guard is recommended to help protect the patient’s lips and tongue, and I find that it is best to align the teeth first before performing IPR.

3. Collaboration software. We’ve all heard the advice, “Work smarter, not harder.” As a business owner, success depends on working smarter, and collaboration software is an ideal tool for doing just that. My office depends on the Slack app, which combines email, text messaging and chat for communicating with your team in a way that’s better than traditional methods. It also includes file storage and categorized conversations, creating channels for different types of communication. In short, the program enables my team to communicate in a highly efficient, productive and flexible manner.

Slack also integrates with G Suite, providing our team with secure and user-friendly email, cloud-based and collaborative word processing, and data storage. We also have incorporated Teamline, a project management application that seamlessly integrates with Slack. Essentially a reminders app, Teamline makes it easy to assign tasks and set deadlines for team members and provides a clear view of everything happening within the team. Best of all, it eliminates the need to follow up with team members when tasks remain unfinished.

4. Digital marketing. When I started my practice from scratch, digital marketing was a major reason we were successful. It was invaluable in getting the word out, and thanks to that success, we’ve opened two additional practices in just six years. There are countless digital marketing options available, but I’d like to highlight two I’ve found very useful in my practice.

First, I’m fortunate to have co-founded the digital agency Neon Canvas, and one of the main benefits is that I was able to build the custom WordPress website of my dreams. Because of this and other ongoing SEO strategies, my practice, Saddle Creek Orthodontics, ranks at the top for a host of search terms and we collect dozens of leads each month from Google, Facebook and Bing. The Neon Canvas analytics dashboard also allows us to see our marketing stats in real time. The dashboard combines all pertinent information to provide a snapshot of ROI, enabling us to see what’s working (and not working) so we can make prudent decisions on where to spend our marketing dollars.

Secondly, Dentma offers a program called Ava, an automated virtual assistant that facilitates follow-up on our consults who don’t say yes to treatment. Ava integrates with our practice management software and extracts that information daily, taking care of tracking and communication as if “she” were you. I find people respond best to text messages, so we have Ava reach out in that manner most often. The bottom line is that you’re trying to get a “yes” or “no” as quickly as possible, and Ava helps to streamline the process and make sure our follow-up is executed consistently.

5. Take a look at your burs. Burs are something we often take for granted, because we repeatedly order the same ones over and over, year after year. I urge you to regularly re-evaluate the burs you’re using and take a look at new instruments as they become available. If, for example, you’re using the same bur block you were given in residency 10 years ago, maybe it’s time to see what you’re missing. Every instrument you and your team use, from lab carbides to ceramic burs, is worthy of review. If you have a few favorite burs, take some time to work with a product specialist to stay informed about updates and new developments, and work together to create a custom bur setup that best addresses your daily needs.

A major change to my bur block has been the addition of the Komet CeraTip tissue trimmer. It’s faster than the soft-tissue laser I use, easier for the team to set up and there’s no need to pull out the laser and protective goggles. The CeraTip cuts only on gingival tissue and I find it’s very useful for simple canine exposures. Every minute saved at chairside is a minute I can dedicate elsewhere in the practice, and bit by bit, those minutes add up to streamline workflow and efficiency.

Filling in the gaps
Only so many lessons can be taught in the classroom, and it’s up to us to fill in the gaps by sharing tips and methods we learn through experience. Any little thing that simplifies and improves the therapies we deliver to patients should be shared to enhance clinical care and maximize efficiency. Remaining open to novel uses for instruments and techniques can make the overall orthodontic practice more efficient, more enjoyable, and more clinically and financially successful. I encourage you to look at your routine and, on a daily basis, consider what you can do to advance your practice while optimizing the office culture.

Author Bio
Author A 2013 graduate of the University of Tennessee Department of Orthodontics, Dr. Kyle Fagala is a board-certified orthodontist with two practices in the Memphis area. Fagala combines cutting-edge treatment with personalized care to deliver beautiful smiles every day. He is an expert on the topics of orthodontic social media and digital marketing, is co-founder of Neon Canvas digital marketing agency, serves as a KOL and works closely with the product specialists at Komet USA, and hosts a web series (The Digital Orthodontist: Live!) aimed at helping orthodontists improve their practices and lives.


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