Using Microscopes to Provide Better Patient Care

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Dental Tribune
By Fred Michmershuizen, DTA
Feb 23, 2009

Dr. Donato Napoletano started his general dental practice in 1988 in his hometown of Middletown, NY, USA. From the very beginning, his practice has focused on three key philosophies: prevention, early diagnosis, and minimally invasive intervention whenever possible. To achieve his goals, Dr Napoletano has always relied upon the best technology available. He uses CAD/CAM systems to design and fabricate all-porcelain restorations, and he uses lasers in diagnosing and treating carious lesions early, in removing soft tissue lesions, and in treating moderate to advanced chronic periodontitis in patients who desire an alternative means of therapy to conventional surgery. But Dr Napoletano says the most important tool in his technological arsenal, by far, is the dental operating microscope.

“I use a microscope with just about every patient I examine or treat,” Dr. Napoletano says. “In addition to enhancing the use of other technologies I use, the microscope also helps to enhance and augment just about all aspects of dental practice that I can think of, including patient management and patient education.”

Napoletano, who is so excited about his microscopes that he offers a dental microscopy course for fellow restorative dentists, spent some time recently discussing microscopes with Dental Tribune.

How long have you been using microscopes? What can they do?
I have been using the dental operating microscope for over five years now, and I consider it to be the most valuable piece of technology I use. This equipment has truly transformed the way I practice dentistry in ways I never imagined. I currently have six microscopes, one in each of my six operatories. They are ceiling-mounted Global Surgical G-6 models, which offer six steps of magnification. All of my microscopes have SLR digital cameras and live video cameras attached to them. The video feed, which is directly connected to the operatory, computes and bridges to my practice management software so that images can be easily captured and stored in the patient’s chart.

How many microscopes do you have?
I currently have six dental operating microscopes, one in each of my six operatories. They are ceiling mounted Global Surgical G-6 models, which offer six steps of magnification. All of my microscopes have SLR digital cameras and live video cameras attached to them. The video feed which is directly connected to the operatory computes and bridged to my practice management software so that images can be easily captured and stored in the patient’s chart.

What was it like working with the supplier and getting them installed?
With Global Surgical’s very experienced and knowledgeable team, the process of having my microscopes installed was a truly painless experience.

Have you recouped your investment in this equipment yet? If not, when do you plan to?
Although the return on investment (ROI) for the dental operating microscope (DOM) is not as easily quantified as other technologies such as CAD/CAM or lasers, I personally feel that there is no other technology I currently own where I have recouped my investment as quickly as my microscopes. The funny thing for me was that I never acquired the microscope with any preconceived expectation of an investment return in mind, as I honestly believed they did not have any. To my surprise however, my earlier beliefs regarding ROI could not have turned out to be more wrong.

There are many factors that contribute to the realization of investment return, but the most evident are increased visualization and having the ability to efficiently document and share what is observed with patients prior to, during and after treatment. Both of these factors results in an increased level of patient communication, increased patient confidence and, most importantly, increased level of trust established in much shorter time periods. All of these factor byproducts ultimately lead to increased case acceptance, which in turn can produce a significant return on investment.

Sounds like your practice is very high-tech, very cutting-edge. In what other ways does your practice stand out?
Other ways I feel my practice stands out is in the amount of time we invest to educate our patients. Since becoming an avid microscope user, using them even for oral examinations, the amount of time it takes me to diagnose problems, educate pts to treatment options, and gain acceptance has been significantly reduced.

How does having microscopes in your practice enable you to provide better patient care?
The microscopes give me increased precision and a higher level of confidence that all decay has been removed. When utilizing lasers, the microscope is very helpful in better observing laser-tissue interactions. Most importantly, however, the microscope enables me to better diagnose problems early and effectively communicate these problems to patients so that they are better able to accept treatment recommendations. The key to offering patients better care is first getting them to agree to it, which as we all know can be challenging with some patients, especially if they are new to the practice or are not currently experiencing any symptoms.

What other advantages do the scopes give you?
One of the most significant advantages to the operator is improved ergonomics through better posture. This enables the clinician to operate more comfortably for longer periods of time without breaks. This obviously improves one’s level of efficiency and productivity, since more treatment can be provided in fewer visits. This has also helped increase new patient referrals.

Is there a long learning curve? Are any training opportunities available?
The amount of time required to fully integrate microscopes into a practice is obviously going to vary among practitioners. Without proper training, the time required to fully integrate microscope to practice will no doubt be longer for some, and others may not integrate them at all. The only bad technology is technology that is not being used to its fullest potential or, worse yet, not used at all. I am very dedicated and passionate in helping other restorative dentists discover the many advantages and benefits to dental microscopy trough education and hands-on training programs utilizing mannequins and microscopes in an operatory setting. My dental microscopy course for restorative dentists is designed for new users, but it is not restricted to microscope owners. Dentists who are undecided about whether or not a microscope will work for them can benefit too in that it allows them an opportunity to explore and practice before they buy.

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