The Group Dentistry Now Show: The Voice of the DSO Industry – Episode 222

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Welcome to The Group Dentistry Now Show: The Voice of the DSO Industry!

Elevating Dental Assistants: Training and Best Practices for Clear Aligner Therapy

Our latest episode featuring two incredible guests, Shannon Pace Brinker, CDA, Founder & CEO of Chairside Assisting & Angela Severance, Training & Education Mgr. for DSOs of Ivoclar. They bring a wealth of knowledge and experience in the dental assisting and education space. We had a fantastic discussion about the challenges and opportunities in clear aligner therapy.

 Here are three key takeaways that stood out:

• The Importance of Consistent Training

• Understanding Materials and Techniques

• Navigating Insurance and Documentation

To learn more about clear aligner therapy education and how Ivoclar can assist your DSO with education and better patient outcomes reach out to Angela Severance at [email protected]

You can learn more about Shannon and Chairside Assisting at https://www.chairsideassisting.com/

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Training and Best Practices for Clear Aligner Therapy DSO podcast transcript:

Welcome to the Group Dentistry Now Show, the voice of the DSO industry. Join us as we talk with industry leaders about their challenges, successes, and the future of group dentistry. With over 200 episodes and listeners in over 100 countries, we’re proud to be ranked the number one DSO podcast. For the latest DSO news, analysis and events, and to subscribe to our DSO Weekly e-newsletter, visit GroupDentistryNow.com. We hope you enjoyed today’s show.

Bill Neumann: Welcome everyone to the Group Dentistry Now show. I’m Bill Neumann and appreciate everybody checking in today with us. This is going to be a great conversation. And we are just recently back from the Dykema meeting and it took me a couple days to recover. Great meeting. And I had the opportunity to meet one of our guests for the first time in person at that meeting. And Ivoclar actually had a special dinner for, I think it was, and Angela will correct me if I’m wrong, but about a dozen or so international DSOs. They actually brought in DSOs from Germany, Austria, Australia. I may be missing a country or two there, but it was really a great chance to learn what’s going on. in, in other parts of the world when it comes to challenges and successes and some things that are going on. And Ivoclar always does a great job and gives some international perspective on things. So back from that, have a lot to talk about with Angela Severance, who is the training and education manager for DSOs at Ivoclar. And then we have Shannon Pace Brinker with us. And I’m sure a lot of you, especially on the clinical side, knows Shannon. She is a certified dental assistant. Her company is called Chairside Assisting. So we’ve got Shannon and we have Angela with us. Thanks both of you for being on the show.

Shannon Pace Brinker: Thank you for having us.

Bill Neumann: Shannon, why don’t we start with you a little bit about your backgrounds, maybe a download on your bio and then what you do at Chairside Assisting.

Shannon Pace Brinker: Sure, well, I’m Shannon Brinker. I’m a dental assistant. I have been for 34 years now. I’m getting old, but I will tell you that dental assisting is my passion, of course. I’ve taught over 60,000 dental assistants in the United States and really just wanting to elevate the dental assistant. There’s not a lot of champions for us. And so this has really been my passion, but most importantly, you know, bringing really higher-end education to assistants so we can, you know, have them perform better, feel good about themselves. And now we’re trying to make the education super easy by partnering with companies like Avoclar to bring it straight into the practice. And our website is Chairside Assisting, so there’s a lot of information there, but most importantly, we really want to focus on the dental assistant and getting their skills up to the highest level possible.

Bill Neumann: Thanks. And Shannon, I know you work with a lot of individual offices, but you also work with multi-sites and smaller groups and some larger DSOs as well.

Shannon Pace Brinker: Yes, we do. I will say that probably before, right before COVID for almost seven years, myself and I had 81 trainers across the US and Canada. And we have been, you know, have I been in business line offices, which I know we will. That was my team. We actually trained and we were doing probably seven courses a week in all different locations. So we really built a niche and we had to have so many really great trainers that we had about 81. Now we’re down to close to 40 because we’re not traveling as much as we were, but we still want to make sure that we are raising the bar for dental assistants. So yes, we’ve done a lot. So there’ll hopefully be a lot of your viewers that recognize our name and most importantly, remember us in those trainings.

Bill Neumann: Thanks, Shannon. And we have Angela Severance with us as well. And Angela was talking to me off camera just before we started the record. She’s been in the industry a while, but she was telling me she’s been laying low for the past several years. And she hasn’t been on a podcast in a while, but it’s great to have her on. And one of the things that I’ve learned talking to a lot of DSOs is that Training is incredibly important, and most DSOs, save for a handful, don’t really have structured education and training for whether it’s dental assistants, office managers, hygienists, clinicians, you name it. They’re getting a lot of their education and training from their partners like Ivoclar. And Ivoclar has invested a lot of time. I’ve been working with Ivoclar for over a decade now, probably closer to 15 years. And it’s really impressive with the team, specifically on the DSO and group practice side, that Ivoclar has assembled. So it’s, it’s, it’s critical. And I think, you know, again, I just like to emphasize training, because it’s something that a lot of people, a lot of groups don’t necessarily have figured out yet. So Angela, a little bit about your background and talk about what your role is at Ivoclar.

Angela Severance: Sure. I think you probably have, well, there are a lot of training cheerleaders out there, but between Shannon and myself, I think we’re pretty big on training and education. That is our wheelhouse. It’s our baby. So I’ve been in dentistry for 25 years. I actually started off as a dental assistant as well, and 10 years clinical. And I do have to give a shout out to Shannon because I met Shannon back when I was starting in the education side. And I met her and I was like, oh, I want to be her someday. She’s inspired me. So Shannon, I do have to give you that shout out because I met her, I think back in 2006, and I was just getting into CAD CAM. So that’s really where I transitioned my clinical role into education. So the last 15 years of my career have been solely focused in education, training and implementation of technologies into practices. taking that knowledge and then partnering with manufacturers to help them develop training and education that actually are relevant to what the goals are of the group, of the practice, dependent of what technologies they’re implementing. So that’s what I do with Ivoclar, is I work directly with our DSO team. We have an actual dedicated team and we partner as a team with DSOs, and we look at what are their goals, and then we break things down from there to create educational opportunities for them to reach those goals. So, yeah, I’m extremely passionate about it, and I’m very excited to talk about that today.

Bill Neumann: Thanks, Angela. And again, I worked with Ivoclar for a while, in fact, when I was in the field and I worked for a competing company that sold similar products. We always looked up to the Ivoclar sales team, including now the DS, I’m sure there probably weren’t DSO representatives way back then, but just the education that the team had as sales representatives, territory managers, it was pretty incredible. So kudos to Ivoclar for really educating the teams well, and now of course you’re out there training, the group practices and the DSOs. We’re going to focus on clear aligner therapy. And you kind of look at some of the challenges DSOs have had, and they’re really looking for, you hear a lot about same store sales and organic growth. And there are a lot of organizations that might have been doing a little clear aligner therapy, and they’re trying to bring more and more of that into their practices. So let’s talk a little bit about some of the common challenges or breakdowns when it comes to workflow. And maybe we can start with you, Shannon.

Shannon Pace Brinker: Well, I will say that we all have them. So it’s just, for me, I think the key points here are always isolation, understanding that we’ve got certain procedures and we’ve got to follow those protocols or those procedures. But what we see is the isolation, the selection of products. One of the things that we’ve done several times with assistants, and matter of fact, we just did this a few weeks ago, is show us your setups. For me, that’s an eye-opener when they’re setting up to prepare for that patient. We’re seeing all these different products and really things laid out. For me, I think that you’re only, as I’ve always said, you’re only as good as the person that trained you, but the inconsistency and the knowledge of the dental products that they’re using. they don’t even sometimes even know the name of that product or the brand. You know, especially if I’m asking, they’ll just tell me, oh, it’s a blue syringe. It doesn’t really, they don’t really, really pay attention to brands and multiple brands. And that’s an issue. So I think the inconsistency of the products that they’re using, and again, not having the training, you know, one of the things that I pulled up this morning, I wanted to have really, you know, solid numbers of dental assistants. There are over 600,000 dental assistants now in the United States. only 30,000 are certified. So most dental assistants are either getting training on the job, they’re getting trained by the doctor maybe right at the chair, or they’re getting trained by a dental assistant that’s within that practice. And so again, you know, if the person that’s training them doesn’t have the skill set to really train and train accordingly, these are the things we’re seeing. And so the only way that we know is asking questions, you know, just like Angela was talking about, you know, operator, you know, watching and visually watching someone operate is not going to be the way it’s going to register when someone doesn’t have, you know, again, the training for a lengthy period of time. So for us, one of the things that I want to make sure of is that you know, they feel confident. And I think where we’re missing it is I’ve always done hands-on training because I’m a tactile worker. I like to work with my hands. We know when we do a course and there’s a model in front of us, they won’t even listen to us anymore, right? They want to touch that model. And I think one of the things that is beautiful about our relationship and the partnership with Avoclar is they know that as well. They see that firsthand. So for me, I think we’ve got to back up a little bit and really not just put a dental assistant in the chair and learn at the chair with a patient because of that anxiety, you know, and we’re making mistakes and we don’t want to look bad, but we also don’t want to make the practice look bad or make the doctor look bad. The way to build the confidence is going back to those basics of let’s train off on the side and let’s give you some type it on let’s give you some protocols again the isolation the proper products I mean the one thing is sometimes they’re just so many products which we all know in dentistry it does get confusing there’s no reason to say that, oh gosh, they’re going to remember all these products. They’re never going to. But the problem is, is we have so many products, we can stick with the same manufacturer and use those products across every clinical procedure. And I think this is the biggest misconception. So again, lots of things that we see now of why, but if we go back to that training and looking at, you know, what are some of the things that are happening, it’s the products, it’s the proper isolation, and just the overall training that they had from the beginning, I feel.

Bill Neumann: You mentioned something pretty interesting at the beginning, Shannon, the answer to that question, which was inconsistency. Angela, do you find that there’s inconsistency even within the DSOs that you work with and train?

Angela Severance: Oh yeah, absolutely. I want to say that for implementing anything new into the practice, you know, technologies, material workflows. Nobody likes change. So when, and Shannon mentioned it, it’s standardization. When you’re working across multiple group practices, how do we get consistent? And to me, ultimately, it starts with leadership. So many times people ask me, like, how long is it gonna take me to get good at something? And, you know, the answer truly is, it depends. It depends on how committed you are, how engaged you are to continuing to learn. And so we have to turn that inconsistency into consistency and it’s obviously it’s going to have to start with leadership. I think leadership is the key. Leadership has the vision. Leadership gains the buy in from the group. When you gain the buying from the group now you partner, you know, with someone like I have a car that that’s there to support you. And so we then work together to turn that inconsistency into consistency through education. And what that looks like is starting at the local level, whether it be a pilot program. I find that to be a very, very good stepping stone is let’s start with a small group and let’s figure out versus trying to go through the masses and say, this is what we’re going to do now. That’s not going to gain any buy-in. We need to start with a pilot program where we can work with the group And we can start with that local level of training. So the local level of training and we all know it’s we’re in a busy practice, we’re gonna remember what 30% of what we just learned. So from there, what we do is we, we actually have online learning program called the Learning Pathways. Now that Learning Pathways is a beautiful way to continue to build on that initial foundation. It’s also an awesome thing to have for new hires. We all know that team turnover is a true challenge. Having that online learning program there to support new team, to support team turnover, that’s where you’re going to get that consistent message versus, as Shannon mentioned, learning from the assistant or the assistant that maybe just started three months ago, that learned from the assistant three months ago, or from the doctor. So this online learning platform is a great way to continue to build on that foundation. And now we all know when you implement new things, yeah, there are going to be inconsistencies. We’re going to face hurdles. You’re always going to face some hurdles. We don’t know what we don’t know when you’re implementing new processes, new aligner therapy programs, new technology into the office. And so what we like to do then is take it to the next level and do hands-on. Again, Shannon and I are going to mirror each other a lot. I can already see it. It’s hands-on learning. where we’re really going to take that knowledge now and put it into action, get our hands dirty, work with the materials, be able to ask the questions from the key opinion leaders, from the people that are working with these materials, these workflows, every day, all day, so that now, whenever you leave a hands-on program, you’re going to leave with these aha moments, golden nubbets, tips and tricks, pearls of wisdom, whatever you want to call them. And you’re going to take that and you’re going to implement it. And now all of a sudden, you’re going to start gaining confidence. When you start gaining confidence, that’s where the consistency is what drives the confidence. So it’s building those programs and then not just stopping there. It’s continuing. When we stop knowing, we stop growing that whole thing. So now we’re going to work directly with the DSO and go, okay, we’re feeling good, we’re implementing, we’re finding success. Now, where are we going? What are we doing next? And so it’s really customizing those educational layers within the groups to help them achieve their goals. It’s ultimately that it’s a commitment, right? It’s a partnership, but it’s us developing initiative. and then driving it together to really make it a sustainable, successful program. That’s where you’re going to get consistency.

Bill Neumann: Shannon, when it comes to effective strategies for onboarding new assistants or maybe some team members that are already there, but get them involved in the aligner workflow, what are some of those effective strategies?

Shannon Pace Brinker: Yeah, I think right out of the gate, just understanding, you know, all the products, and most importantly, going back to the hands-on training. I mean, what is so great here for anyone who’s listening is, you know, Angela’s a dental assistant, and she’s the connector from you to clinicians like myself. And I’m a dental assistant. Dental assistants really want to hear that when they know that we’ve sat in the chair and this is what we do. And listen, there’s a lot of areas that, you know, I had to practice. I mean, I’m sitting at home practicing myself. I mean, I’m the only assistant that has a waxer and had a CABO station at home, you know, working on typhonates. there’s nothing to be ashamed of. I think this is where we have to practice, but we don’t want to practice on a live patient. We want to practice on models to give them confidence. So when we talk about, we thought right out of the gate, no one has the best or has anything better than the composite we’re using. And just so you know, I mean, Avoclar didn’t come to me. I came to them. I mean, I had already taught 20,000 dental team members for Invisalign. I mean, this is something that we know and when we use their products, it just made it easier. But when we start and we think about aligner therapy, it’s not just aligner therapy. This is a full whitening to restorative. Anyone that’s going to do whitening or they’re going to go ortho, that’s number one, number two, they’ve got to have a restorative component. And so for me, I want anyone listening to really think about this, at the end of the day, there is going to be some type of restorative, whether it be a direct resin, crowns, implants, whatever. And this is where I think a lot of other manufacturers really are not really looking at that message, whitening to restorative, right? So a line of therapy, we want to move the teeth, get them in the right position. But if we can start out with having team members understand that, using really good products. And what I love is just everything is so efficient. I mean, I just trained in office last week. I’m going to tell you, they take an hour and 20 minutes to deliver attachments. And that’s crazy. There’s no way they’ll be able to ever really enjoy it. And most importantly, they were doing one attachment at a time. And I was like, who trained you? And so when we were finished, the one thing that I will tell you what is so great is they’re like, oh my God, we didn’t realize how simple this could be. But most importantly, they thought they could only use Avoclar products just for placing attachments. And I said, are you crazy? I work in a practice. this is the same composite. You know, you can use one manufacturer and then the team starts to learn, oh my gosh, I didn’t understand that we could just use the same manufacturer’s products. And then they understand because they’re made to go together. Where we see failure is when we start mixing this bonding agent with this composite. And to me, I feel like that’s the reason why attachments come off. I mean, I cannot tell you the things, and again, team members will tell us everything, uh even their blood type you know i mean but that is what is beautiful and i think when angela talked about you know having that person that’s going to be your contact like her she’s going to really interview you to make sure and find out what those pain points are so we get them head on but again i feel like when we talk about attachments coming off debonding not using proper isolation just using cotton rolls not making sure and again this is bonding even though it is attachments you know it’s not a final restoration But, you know, I want to make sure at the end of the day that, you know, everything’s isolated. I’m using really good bonding agent. Now, I was an evaluator for Michael Miller. I have to give Michael Miller a lot of credit. He told me, one of the first things he told me, I could not be an editor. And he said, you never, ever mix manufacturers products. and you know he is so spot on i give him so much credit for that and i just i’m so happy he and he really uh bestowed that upon me because he’s right the failures happen when we are mixing this manufacturer with this manufacturer because so many people think that that’s okay and it’s not um not having a really good cure light oh my gosh i mean having a cure light that’s got 10 layers of bonding agent on the end of it or composite um you know something that takes 20 seconds you know keep hitting the button 30 seconds we just we don’t have that kind of time and so taking someone that’s taking an hour and a half to place attachments and in one training they’re able to deliver upper and lower attachment 28 attachments he just texted me on monday angela 28 attachments in 20 minutes that speaks volume. So we can do this type of training and really get these teams to love in dentistry again. I think this is what’s happened is we just don’t love dentistry. Like we had this passion, we were excited about it. Go back to the basics. Let’s get type of training with Avoclar’s help, having the rep there, we’re here, and really making sure that we’re doing things the right way and building the confidence, not just to assistants, but everybody on the team, And now we can take it to the patient because I know what I’m doing and I’ve perfected that skill.

Bill Neumann: Shannon, that’s a great point about mixing manufacturer products. And I’m sure DSOs can fall into that trap very, very easily, whether it’s a pricing concern or whether it’s just excess inventory that they have that they want to use up or even maybe a team member that’s not know, educated. So you’re really talking about, you know, almost like a system of products, right? This, this family, this suite of products. And then you’ve got the training on top of that, because certain, as we know, whether it’s bonding agent or, right, it They all, and you have different generations and some don’t work well together. And when you talk about a failure, you’re talking about a patient, first of an unhappy patient, a patient having to come back in for another visit in a lot of cases. And of course that’s time and all the, maybe the cost savings that they had with a less expensive product, that’s all negated several times over because of the patient having to come back in and that failure.

Shannon Pace Brinker: And you know, Bill, one of the things that I do want to mention is, you know, working with Align so closely. I mean, really, I mean, I was their CE educator. I mean, we did so many courses, we had to. There’s not any hands-on attachment training. We got to have that. You can’t just have somebody jump on and watch modules. I mean, we need really good training, and that’s what we’re doing with albaclar. I mean, we are really making sure that they understand that. But the thing is, and this is what I hear from dentists, because they’ll call me and they’ll tell me, hey, Shannon, the issue is a patient will get to a line or 20, and they’re not getting the movement that they really needed. And you got to back up a little bit. for any reason, if they just use a flowable, you know, a composite, again, based upon what they were trained or how they were trained, you know, we’re using stiff, heavy body composite materials, we’re using instruments, we’re overfilling the attachment template, and I know that some of your viewers may not even understand what I’m talking about, but if we were to underfill the template to place the attachments. That will be one of the main reasons why we’re not getting the movement. So when you think about this, if you’ve got a patient on liner number 19 and they use, you know, a flowable and didn’t use something that really could push the teeth, you know, We’ve got attachments on the teeth to move them into place. We don’t have brackets and wires, but if there’s not enough composite in that attachment window, when that attachment was placed, that could be the reason why the teeth are not moving. And so for me, it’s like, you know, the team doesn’t understand that 100%. So here we got to rescan the patient. We’ve got to give them, they were on a lighter 19, maybe they only had 35 to start with. Well, now they almost like starting all over again. And guess who gets the blame? honestly, it’s to the point where we really and truly have to go back. And what we found was by switching to Avoclar’s composites, not only do we have a really heavy body composite, we can pack it in, team understands, because the more complex the case, which is where we want you to get, you know, you got easy cases, But we want you to get to the harder cases. You’re never going to get there if you don’t get enough under your belt. But there are some of these teeth that have two, three, and four attachments on them. So it’s so important to make sure that the team understands because it’s not just we’re just going to put a bunch, put some flowable composite into a tray and just seed it. We’ve got to move the teeth. And so for us, that’s a lot of money. When you’ve got to rescan, you’ve got to go back through and start from scratch again. But most importantly, what is that patient going to feel about the practice? And the doctor, the confidence is lost. We’re going to build that, but we’ve got to have the proper training so the team understands what are the mistakes. Because listen, there’s no mistake that they could make that I haven’t already made. And I think that’s what’s beautiful about having two assistants, right? I mean, they just don’t admit a lot of the mistakes. We’ll tell you everything. But the most important thing is, is again, they didn’t know. And so this is where I feel like having, you know, myself on one side, you got Angela, who’s going to make sure that we’re going to ask you all the questions, find out who you are and not just drop in a cookie cutter. I mean, we’re really and truly trying to figure out what do you need? But I think it goes back to also working with the reps in the field, because this way, we’re going to bring the education to the practice. We’re building models, we’re building kits, we’re building this. And just like I know you said, the turnover. I mean, right now, all we’re hearing about is hygiene turnover. Please, what about assistance? I just told you 600 and something thousand. Who’s training them? And this is why Angela and I both have dedicated our whole lives to we got to train them. There are some amazing assistants out there. I have 83 trainers. They’re better than me. I’m no dummy. I surround myself with really good people. They’re really good. These assistants are amazing. Every Every group has some amazing assistants. And so one of the things that we really want to try to do is maybe train the trainer, train that, train your group of assistants and make them the trainers for the rest of the group. Cause I know most groups want to be there or have their own people, but we can give you the skill sets. We can give you great materials and we’re going to give you the systems. That’s what’s missing. And I think that’s, what’s going to be different because we’ve got guides, we’ve got downloads, we’re building workbooks. but we’re building strategic workflow. And again, at the end of the day, you talk about money with products, but what people don’t understand, and I teach inventory control, I teach budgeting, and I can tell you that what you don’t really know is when you can use the same manufacturer for so many procedures, you have cut your cost by 20% if not more. So this is where I think, you know, when we’re using all these different products and we’ve got all these different products, you’re really not doing any good for yourself, but you’re also not teaching your team that these go together and not just grabbing things. Because a lot of times I’ve seen assistants, they’ll pour something out of a bottle and hand it to the doctor. Does the doctor really know what I just handed you? Probably not. And so this is where again the training and and these assistants are amazing. They just need a good trainer and need someone to to really make sure that they get it and giving them the confidence so they’ll stay in your practice. I think this is the one thing it’s not people say oh it’s about money you know we got to pay more money. Honestly if you interview most assistants it’s I want to have the training I want you to elevate me and I’m going to owe you you know I mean I feel like you give me the training right and I mean you give me the training I’m going to be more dedicated to you because you invested in me. I can’t agree more.

Bill Neumann: So, Angela, you’re obviously involved in a lot of these programs. Talk a little bit about getting the staff, the assistants up to speed. What’s your experience?

Angela Severance: You know, Shannon hits so many brilliant points and it’s the continued, you know, getting them up to speed takes, I’ll say it a million times today, commitment and engagement. So there are many amazing assistants out there and maybe there are some assistants that don’t necessarily care to grow. I used to say there are two different kind of assistants. You know, we’ve got our assistants that maybe just are okay. This is just going through the flow. I don’t necessarily want to elevate, and that’s okay. We need everyone working together as a team. When you have the assistants that are maybe your dentist wannabes, we call them ninjas, and that really are looking to grow. For me, at least, it was the more I could get my doctor out of the operatory, the better my day was. No offense to the dentist, but in your faith. For them, it’s great because now they can be doing what they went to school for, anesthetizing, restoring teeth, diagnosing, running businesses, and I can be using all those skills that I’ve been empowered to use. And so when you have peer-to-peer education, and that’s something that we’re priding ourselves on from Ivoclar, is making sure that we have that peer-to-peer education, whether it’s the dentist, obviously being a materials manufacturer, maybe not as much office management education. However, all of our CE, online CE, is great for the entire team to know, because then everybody’s speaking the same language. But as far as getting the assistance up to speed, it is that engagement. So making sure that they have, you know, I’ve done a lot in customer success and customer success is a concierge, is having that person, that peer to lean on. I mentioned it earlier. Shannon was a mentor for me. And when you have somebody that’s empowering you, not just from a peer-to-peer standpoint, but then also taking that to the dentist. And I’ve taught plenty of courses just to dentists only on team communication, because I would get a dentist that would come up and ask me, how do I find an assistant like you? Or how do I do? And it’s like, well, what are you doing to empower them? So I think that there’s a combination factor there is having that peer-to-peer education, but then also knowing that the person that they’re sitting knee-to-knee with, nose-to-nose with, believes in them and is there to empower them and build that confidence.

Bill Neumann: So we talked a lot about the importance of materials. Shannon, maybe let’s get a little bit more focused on that and go through some details like what materials when it comes to clear aligner therapy and maybe specifically attachments matter most.

Shannon Pace Brinker: Well, the first thing that matters most is the isolation. That is the most important thing. And, you know, I will tell you, I train a lot of orthodontic practices and I’m like, oh my gosh, you know, no cotton rolls, right? We need proper isolation. And now with the Optrigate, and everybody knows what the Optrigate is, but now having the Optrigate 2, It’s even better, you know. And for me, I think that we’ve got to get the lips off the teeth. And it was one of the number one things of just that group of friends I talked about last week. They were just using cotton rolls, you know, and trying to do this. And I said, oh my gosh, you know, this is, that’s number one. We’ve got to be efficient, get the lips off the teeth, especially when we’re working by ourselves. And so I think the object to having that proper isolation, understanding the steps, understanding the steps, because again, I love Align, don’t get me wrong, and I work with a lot of other Aligner companies too, but a lot of teams are not gonna jump on and watch a webinar of the whole process. So for them, one of the things we do is we will train them a little bit more on the process so they know what happens next through Um, from start to finish from scan to delivery. Um, but I feel like with the, um, you know, with having the templates and the series of aligners and how should we be delivering those, um, proper etching technique, you know, not altering the attachment template. I can’t tell you. I mean, people told me, oh, do you poke a hole in it? You know, can we cut it? Can we use PAM? Who’s telling you these things? And understanding, again, the proper bond technique, you know, making sure that we’ve etched long enough. The one thing that we see a lot is everything in dentistry is so slow that they’re not really using timers. And you say, Shane, you use a timer? Absolutely, I do. Because again, even for me, from the time that we etched that first tooth, they’re just starting right then. It’s like, no, wait a minute, you etched this tooth a lot longer down the road. So just kind of giving them, I think, the best practices, but most importantly, having them understand if it’s not frosty, you got to go back and re-etch. That’s another thing. Using good bonding agents. they’re not all good. And so for me, though, I will say the one thing that I love about my T’s pin is that that’s a misconception. You know, when we talk about ergonomics and really trying to be efficient, this practice was using a different bonding agent and and most importantly using it in a bottle. And I said, oh my gosh, when you touch this pin, it’s like when assistant touches that pin one time, they never want anything else. And he said, yeah, but my doctor’s not gonna let me do this because there’s no way that we’re gonna be able to utilize this on as many patients. And I said, oh no, over 160 patients in this one pin. And I think clicking that and using it, but again, going back to the hands-on, when we’re doing the hands-on, it’s like they have the time to really listen and do it themselves. And then when he clicked the pin, it was like, oh my gosh, I’m getting this today. I got to get him to get this today. And that’s the excitement for me is to have the understanding because guess what? I had already been through that with my dentist. He was like, oh no, no, no. We’re not going to have enough in that pin to to really justify us switching from a bottle to that. And I was like, watch me do this. I mean, I don’t have to go back and forth, back and forth. It was just scrub, scrub, scrub each tooth. And he was like, oh my gosh, I said, look how fast this was and so accurate. But the one thing that I think is important about utilizing an adhesive pen is the fact that I can take the brush and go straight to exactly where we etched. It’s amazing what we see in the technique. And we like to watch them do it, see how they’re doing it, again, asking them questions about the way that they’re doing things, and then come back and say, let me show you how we should be doing this. You’re not etching the whole entire tooth. only etching where the attachments are going to go, and then taking the adhese right where that’s going to go, scrubbing it in, just watching their technique of how do they place the adhesive. They never really were properly taught, and not all adhesives are the same. One is a paint, one is a mop, one’s a scrub. These are the things, again, they don’t know until they know the brand. And this is why brands are so important. I go crazy when I say, well, what product are you using? I don’t know. they have to know the brand, because that has to be documented in the chart. And so these are the things that it’s not just about that, it’s proper technique, but most importantly, owning up to it, understanding the products you’re using, knowing how they’re used, because that assistant is probably gonna end up training someone else too, right? I mean, they’ve got big practices, but most importantly, the composite. The composite, I will tell you, translucent composite that mimics natural tooth structure, it’s hard, it’s concrete, It doesn’t come off. My rep actually went to another doctor to have her attachments placed. And do you know, by the time she left that night, this is the Invisalign rep, 12 attachments. Do you know, by that night, 11 of those attachments were off. She called me, she said, Shannon, I don’t know what to do. Can you put on my attachments? And I’m like, I’m, you’re not our patient, you know, what are we going to do? And I said, What did they use? And when she told me, I said, well, first of all, they’re using the wrong bonding agent that really should never be used. They use a flowable composite, but it’s not their fault. They just were not properly trained. And so this is where, again, partnering with the reps, partnering with, you know, again, let Angie be the gatekeeper. Let’s partner with the reps, making sure that they’re on the other side as well, because we need an army. But I think, again, it goes back to having a consistency, having the workbox, having the models, doing training, show them step-by-step, having the guides and the understanding of why, why are we doing this? And the one thing about aligner therapy that nobody trains, even align, is porcelain. I mean, what do we do when we’ve got porcelain restorations? You know, Avoclar is the only person, they came into my dental practice and we shot a video of how to place an attachment on porcelain restorations. And it’s like, oh my gosh, it was the first thing. All I said is, hey guys, they said, Shannon, what is probably the number one thing you think we need to video? And I said, porcelain. You’re the number one porcelain company. Can we please just do a little segment on placing attachments on porcelain? Because it’s not the same way that we place it on natural tooth structure. And I will tell you, I was shocked at how many dentists came out and said, oh my God, what a great video. It was like five minutes, but it was so informative. And these are the things and tools that we’re putting together with the help of Avoclar. So again, can’t say enough. It’s not that they came to me. I went to them because we already placed so many attachments. They were not falling off. And that at the end of the day is what’s going to give us the movement and it’s going to allow us to finish on time. and that’s what we need to do for these patients. So we can move on to the restorative if that’s what they need, which is the bigger picture, right, for any practice. So again, I know it’s long-winded, but I want to make sure you understand that, you know, these things are so important and sometimes we forget that in the eyes of our team members and how they’ve been trained. And you can’t do it yourself. A lot of them say, well, I can train my assistant. You say that, but how are you going to train them when you’ve got patients in the chair? It will never happen. And they’re going to get partial training. They’re not going to get the training that they need to have the confidence that they deserve.

Angela Severance: I just want to piggyback off of something that Shannon said that ties into your previous question with how do we get the assistance up to speed, the team? And Shannon said, why? Why are we doing this? And that’s something that, I mean, even in dental assisting school, I didn’t understand the chemistry behind the materials. And that’s something that Ivoclar, I think, provides at the highest level is material science. So I can grab the blue stuff and hand it to the doctor and then rinse and dry and then hand a pen or hand a microbrush but I don’t know why I’m doing it. I don’t know why my doctor is using a burr, a certain burr to create a different bevel or a chamfer. So it’s really, that’s the training that whether you’ve gone to school for assisting or whether you’re being trained on the job and a dentist can say, I’ll train my assistant in, they’re gonna get a system training. here’s the blue stuff, here’s the water, here’s the adhesive, here’s the light. Why? Why are we doing this? Why is it important to scrub for 20 seconds? Why is it important to light cure for the full amount of time? Because all of this, there’s so many several opportunities for failure in between there. We don’t understand why we’re taking all of these steps. And so I really think that’s a great point to highlight and where I feel that with our education program that Ivoclar has created with our learning pathways for our DSO groups, it talks about the why behind what we’re doing. Very, very, I don’t wanna say heavy material science, but enough to have that light bulb go off. And that’s going to create that consistency and getting the teams up to speed when you understand the why behind the process that you’re doing, the materials that you’re using.

Bill Neumann: Let’s shift for a quick second from training and education to confusion around coding, documentation for aligner therapy. Do you have any, this is where the DSO’s ears perk up. We don’t want to lose any money. Might be leaving some on the table. So maybe a little help when it comes to documentation and coding. What are some tips and tricks for that?

Shannon Pace Brinker: Yeah, and I’ll tell you, I love this. For me, that was something that I was not, I didn’t think would be coming, but now I’m kind of the official insurance guru for a line. They call me and ask me about all these things, and I’m like, are you kidding? Assistants know enough about insurance to be dangerous. I hate that, right? I’d always pass that off to a team up front. But we had to, because where this started was we were walking patients out with the wrong codes. And by the time they get up front, we don’t know. But the one thing that I will say is, when we look at insurance, trying to train assistants, because again, we’re trying to elevate assistants. We’re not just someone that’s just sitting there passing instruments. And for me in the chair, if I know that a patient has beautiful teeth and they’ve got some crowding, I want to be able to say, hey, you know, have you ever thought about aligner therapy? Ever thought about orthodontics? Ever thought about Invisalign? But one of the things that I will tell you I never did was look in the chart to see if the patient had adult ortho coverage. But the one thing that I learned from my mentors, you know, Charlie Blair, is, you know, he said, you know, just ask him or in the morning huddle, say, who has adult ortho coverage? That’s the first thing we got to look for. And what was crazy, as soon as we started doing that as a team, we found like three more patients every day. And that’s the first thing. The team up front has got to let us know who has adult ortho coverage. So on my rounding slips, I always tell team members who are working up front, make me aware, and then I’m going to bring it up. I’m going to ask. I’m more inclined to do that. The other thing is, is that I think with insurance, We don’t know enough about it, but I don’t want something that’s long and drug out, you know, just we’re visual people. So how I became the guru of insurance for a line, I said, when we seem at this appointment, this is what we walk out. We seem at this appointment, this is what we walk out. But what we need to think about, and again, getting the team to understand is there’s two different benefits. We’ve got an orthodontic benefit and we’ve got a general benefit. as many things that we can use on the general side the one thing about a general benefit is it starts over the orthodontic is only a lifetime so the beauty of having this training with avoclar is and this is the only company i’ve ever been to work with that really is allowing me to talk about codes with procedures because we got to make money let’s be honest at the end of the day it is a business but how many times have we used um you know cervitec and and placed that you know where the attachments were and trying to help desensitize teeth for free for free never really knowing that i could use a code that would get the patient reimbursement and we would be able to bill the patient i love my dentist i mean i do listen they would give everything away for free sometimes you know we got to be careful with that But what we know now is, oh my gosh, there are so many codes and there are specific codes that we can be using that will take away from the general benefit. Digital scanning, you know, using certain codes and just really anchoring that to a liner therapy. and making sure that we’re coding things at every appointment. How I became this is because I just made it simple. I had a placemat and I said at the scans this is what we’re going to do and then the first appointment we’re going to do these and here’s the code. Second appointment here’s what we’re going to do and use these codes but not only were they able to see that but it was a visual. It goes back to having a visual making it simple and most importantly them understanding that that just 101 breakdown of These are the codes you have to use and thinking about retention And move it on. I mean one of the things to you know, you’re thinking about you know that restoratives What if the patient has a space right now? I have a space I’m waiting on an implant and I was able to utilize you know an aligner, basically, or I would say my retention by Vera for replacing my tooth. And guess what? My general benefit is helping me pay for that. And so this is where we could help with those things. Bringing some of that money back into the practice to where we, again, can look at procedures that are not going to steal away from the orthodontic benefit. Let’s save it and let’s utilize the general benefit as much as we possibly can. um and again by the law and listen i i’m straight shooter if you’re not doing something right we’re gonna tell you um because it’s very black and white um and uh and i think most importantly just trying to help you maximize it the one thing about avoclar again that whole restorative pathway everything widening to restorative We want to make sure at the end of the day that every procedure is coded correctly, but we want to help the doctor also make sure that the patient gets that maximum reimbursement. And I love that, because this is the only manufacturer that’s ever allowed me to really look at these codes to help the dental assistant to understand, because most of us will give you the Heisman and try to hurry up and get them up front, but we need to know that. We need to make sure that when we’re putting in what we did for the day, we’re properly coding it.

Bill Neumann: Standardization, you mentioned this earlier, Shannon, that you’ve got 600,000 dental assistants out there in the U.S., all different skill sets, right? From not knowing anything to certified dental assistants and then everything in between. Do you have any thoughts and strategies for creating standardization across multiple locations with multiple assistants with multiple different skill sets? We do.

Shannon Pace Brinker: I will tell you, it starts with, there’s nobody better than Avoclar when it comes to that standardization. I mean, we’ve got to have systems in place. And I will say that I think having an understanding of, you know, having, you know, that complete turnover, no matter how great your practice is, people are going to move, you know, things are going to change, they’re going to move up. I think the first thing is giving them the proper training. And most importantly, you know, if they did have a patient or they have the time, they could go watch a module, work on a model, perfect that skill. Every dental team member has something that they’re really good at. We just got to find it. And maybe I’m really good at provisionals, but I wasn’t good at placing attachments. Well, we have a workbox for that. We’ve got modules for that. And that workbox stays in the practice, so this way they can jump on and spend the time to train and use the right products. And they’re all in that box. They don’t just take things out when they need something. But I think having that training, and this is what Avoclar is going to bring to those practices, having a consistent workflow, but most importantly, really making sure they understand all of these areas and the training would stay in the practice. The hardest thing is for a senior team, and don’t get me wrong, I travel every week somewhere teaching at a major meeting but that’s not real world but we can bring the training to the practice and the best part too is we can keep adding on to it you know adding the next module in the next module but having workboxes from rubber dam placement isolation to sealants i mean maybe what you’re doing right now we got a shortage of of hygienists as well right maybe we’re training assistants to be assisted hygiene where we’re teaching them how to do coronal polishing using proper you know, chromoprocessing techniques, sealants, placing fluoride. People say that’s so elementary. No, it’s not, especially if you didn’t get the proper training. So these are the things that we’re working together with Avoclar, you know, having a provisional one, having a rubber dam. Oh my gosh, rubber dam. People are like, really? No, no, no. Rubber dam, you know, utilizing isolation, packing cord for hemostasis, making great provisionals, understanding restorative, how to treat restorations. This is the big picture. This is what’s coming. Nobody’s thinking about these things. And I think, you know, for me, and again, Angela and our dental assistants, the sky’s the limit for us. We’ve already done all of this. We know what we needed. I just wish someone would have had this from me a long time ago, you know, and I think this is where we’re going to build the confidence. Assistants don’t feel like it’s necessary for them to be certified. they don’t feel that way. But when they’re getting this kind of training, I know we’re going to see that change. You know, again, coming in as a new assistant, I was a rover. That’s like, to me, people make it sound glamorous. That’s the worst. We have five different dentists, five different products. But let me just tell you something. I feel that now with these training modules and the things that we’re putting together, we’re going to see a big shift. And what a dental assistant’s persona is, because it’s already coming. We’ve got a lot of states changing laws. We didn’t even talk about that, and that’s not what this program’s about today, but we need to get back to that training. Again, you want to keep your hygienists, let’s train a really good assistant, and helping them with that assistant hygiene and making sure that we can do great scanning, we can do proper sealant placement, we can place fluoride, we can really do good chronopolishing. You know, everything that really we need to keep the team happy, running, but most importantly, building confidence first. So this way, when I go to the patient, I know what I’m doing. And I think this is what Avoclar does best, you know, is elevating that assistant. And finally, somebody is shining on a dental assistant. I mean, I’ve been saying this for years. No manufacturer really sees us as part of the team. But things are changing now, and now’s the time for us to build that relationship. I just talked with David Rice last week. I said, David, it’s the time now. We need to build the relationship between the doctor and the assistant more than ever. Our skill set has to be leveled up with the doctor now. And Albuquerque is doing that. They’re seeing this and just Open the door and let us in, you know, and we’re gonna help you with that. You don’t have to create it We’ve already created it. We’re already doing it all you have to do is just Get to Angela, you know, and let’s find out what you need and we’re gonna make sure you get it because we wouldn’t be doing this You know, we love dental assistants. It’s it’s our heart It’s who we care about and there are some really good dental assistants out there. All of us have something We just got to find it and bring it out, right?

Bill Neumann: Well, Angela, I think it’s up to you to tell the audience how they can get this ClearAligner therapy training for their dental assistants. And you don’t just offer that type of training. That’s what we’re focused on today. But yeah, the education from Ivoclar and the team there is second to none. So, Angela, how do people find out more about that? And what is that process? And what does the training look like?

Angela Severance: So the training is really the partnership with Shannon. And we create the partnership. We’ve got this beautiful trifecta between Ivoclar , Shannon, and the DSO. So it’s synergy that we work together. Where Ivoclar comes in from the aligner therapy standpoint is of course the materials and the support. So Ivoclar ‘s DSO support is both strategic and hands-on. So we get the best of both worlds from our dedicated DSO team. And we’ve got our key account manager that’s going to first meet with leadership. That’s the first step is to meet with the leadership to really understand their operational goals. things like strategic growth initiatives. Then it’s bringing in myself. So now we’ve got the part of the education team. So our DSO education team, we’ve got our key account managers, we’ve got our marketing, we’ve got education, we’ve got operations. So we all work together to then identify you know, what it is. So for this, it’d be their aligner therapy. Okay, now we understand that. Let’s take a step back and let’s create a roadmap, you know, working alongside with Shannon, of course, and then design, you know, actionable steps, so an action plan so that we can take these steps then to really deliver and partner so that we can deliver that standardization. the workflow efficiency, the clinical consistency, and ultimately the patient elevated experience. So it’s through this partnership and then the support that we offer from Ivoclar, you know, we don’t We don’t wait for our DSOs to come to us and say, we’re looking for CE. We’re already partnering with Shannon. We already have our 2026 educational initiative. We’re creating relevant programs to come to the DSOs and say, hey, look at this is what we’ve got. this is how we’re here to support you. And I really feel that when we create these partnerships with key opinion leaders like Shannon, that’s got this awesome training program on aligner therapy. And like we said, it’s not just aligner therapy, it’s from whitening to restorative. That’s what really is where we see the partnership turn operational and clinical excellence. is through this synergistic partnership between all of us together. So that’s really where I see all of this coming to fruition.

Bill Neumann: Angela, what’s the best way to reach out to Ivoclar to learn more about this education program, this training? Is it to reach out directly to you?

Angela Severance: Absolutely, you reach out to me and I’ll get you in touch with the right people. I’ll get you the right people in the right places for you. So just go ahead, email me.

Bill Neumann: Okay, and for the people that are just listening to this on audio, can you shout out your email address?

Angela Severance: Sure, it’s my name, it’s Angela.Severance, like a severance package, S-E-V-E-R-A-N-C-E at Ivoclar.com.

Bill Neumann: and we’ll drop that in the show notes as well. So people can just click on that and email you easily. And Shannon, Finn, people wanna learn more about Chairside Assisting. That’s pretty easy, right? It’s chairsideassisting.com. So that’s easy. So they wanna learn more about what you do there. They can visit there. Any other ways to get in touch with you?

Shannon Pace Brinker: Sure, they can email me at Shannon at Shareside Assisting. And again, just reaching through Angela, she’s gonna be kind of the gatekeeper so we can make sure we can handle, I’m sure this is gonna be pretty crazy. So we’re kind of making sure that everybody goes through her first. But absolutely, I would love to help in any way. And again, that’s what we do. So would love to do that and check out our website. We have a brand new one coming and it’s, again, have so many great things with partnerships. So always here for anyone who needs any help.

Bill Neumann: Excellent. Great conversation today. I really appreciate, Angela, your time, people over at Ivoclar for sponsoring this, and then, of course, Shannon, you and the knowledge and the education that you bring to the table. And thank you, everybody, for watching today. I think this is going to be great for your clinical leaders, and I think even for the executive teams that have Maybe you’ve been looking for ways to increase same-store sales growth. Maybe you’ve brought in some clear aligner therapy. Maybe it hasn’t worked out quite as well as you thought it might. So this is a way to really educate your teams. And I think the last thought on this is, And I think Shannon pointed to this, it’s not just about the money for your clinical team members. They want to learn, they want to stick around, they crave, they need that education. And I think it’s not always, you know, we don’t always think about that sometimes. So, really appreciate your time today and really appreciate everybody listening to this or watching this. Until next time, this is the Group Dentistry Now Show.

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