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Editor’s Note: One of our primary initiatives is to keep our subscribers informed of new and progressive technologies and treatment options that can impact your practices. Earlier this year, I had the opportunity to meet with John Harris of TruDenta to preview their system and learn about the potential benefit for dentists and patients.
TruDenta is an emerging technology that measures and treats the dynamic forces of the mouth (musculature, tendons, nerves, teeth, joints) and accurately pinpoints imbalances and/or improper forces to assist in addressing conditions such as migraines/chronic headaches, TMD, malocclusion, and trauma (i.e. accident). Practitioners can now create comprehensive treatment plans using a variety of methods to relieve the discomfort and symptoms of many of these conditions.
I recently met with Dr. Tony Stefanou, who after 20 years in private practice now focuses on the business side of dentistry by assisting practitioners in becoming more productive. He also works with dental companies to create synergistic relationships with their customers. He began researching the TruDenta system several months ago and has since spoken to many practitioners who have successfully implemented the system. In his opinion, it is one of the up and coming specialized technologies that will dramatically improve the standard of patient care in the near future. Following is a brief summary of his findings, and a discussion of what the system has done for Dr. Jodi Danna of Plano, Texas and her patients. *Note that neither Dr. Stefanou nor Dr. Danna has received any financial compensation with regard to this publication.
AN INTERVIEW BY TONY STEFANOU, DMD WITH JODI DANNA, DDS, FAGD
Americans suffer from chronic, recurring headaches. Approximately 20% of children and adolescents also have significant headaches. And, according to the American Migraine Foundation, 36 million Americans (about 12% of the population) suffer from migraine headaches.
One in four households in America has a member who suffers from migraines. Migraines are three times more common in women than men, and affect 30% of women at some point in their lifetime. While conducting my own research on the TruDenta system, I interviewed Dr. Jodi Danna of Plano, Texas. As a dentist who suffered from chronic headaches, I knew she would have a unique interest and perspective on what this technology means for dentists and our patients.
DR. STEFANOU Dr. Danna, I know that you have personally suffered from chronic headaches. How did this affect you personally and professionally and how did you cope?
DR. DANNA I have suffered from daily headaches since I was 21 years old. Looking back on things now, I can see a correlation between the removal of my braces with the start of my headaches. Over the years I had undergone MRI’s, chiropractic treatments, massage therapy, eye doctor visits, biofeedback sessions, taken unnecessary antibiotics and sinus medication, and dose after dose of anti-inflammatory medications. With each doctor, I explained the ear pain, the headache pain, and the pain down my neck and behind my eyes. All tests produced negative findings. As the years went by, I began to feel that the doctors thought it was “all in my head.” Personally, the daily struggle affected my entire family. Each day I gave 100% to mypatients and my practice, and pushed through the pain; this left me with nothing to give my family emotionally. My patience was thin and my temper often short with everyone around me. It was difficult to help the kids with their homework, go to their events, enjoy time with my husband or volunteer in my community.
DR. STEFANOU You recently began using TruDenta as a means of diagnosing and treating force related dental conditions such as chronic headaches and migraines. Have you used the system to treat your own headaches?
DR. DANNA Yes. I was initially skeptical but hopeful that this could be a solution for me and for so many others. The treatments have been life changing for me personally. My daily headaches have decreased significantly and many weeks I am completely headache free.
DR. STEFANOU You made the decision to bring the system into your office as a result of this and have been using it for some time now. Tell us a little bit about what kind of results you’ve been seeing with your patients.
DR. DANNA My practice is devoted to restoring and enhancing the natural beauty of my patients’ smiles. We use conservative, yet state-of-the-art equipment and procedures to create beautiful, long lasting results. I pride myself on my high standard of excellence, thorough patient education and a focus on preventive dental health care as opposed to disease care.
We started using the TruDenta system in January and completed our training at the end of March. Since that time we have introduced the system through my hygiene department to all of our patients who suffer from head and neck pain, ear pain or headaches/migraines. We currently have 6 patients in treatment and are seeing amazing results! Several of my patients had popping and clicking in the TMJ as well as very limited opening. We saw immediate improvement following the very first therapy session. As we are near completion on our first patients, I’m very impressed and optimistic. The patients and I are very pleased with the results.
DR. STEFANOU You mentioned that other team members in your office, including your hygienist, have also experienced frequent or chronic headaches.
DR. DANNA My hygienist, Missey, has suffered with daily headaches and fullness in the ears for many years and is now almost completely headache free. She also has seen several doctors over the years and has been told there was nothing wrong. After her first treatment she was headache free for the entire week! My Business Manager, Pam, has such severe bruxism that her teeth are completely monoplaned and her range of motion was severely limited. Both of these women have noticed significant life improvement already as a result of the TruDenta system. You can see Missey’s testimonial about her experience after only 3 therapy sessions on my website www.DannaSmile.com.
DR. STEFANOU Prior to having Trudenta in your office, how did you look to treat or assist headache sufferers?
DR. DANNA I really didn’t offer much in the way of treatment for headache sufferers. Those patients who were TMJ involved were either placed in a bite splint or referred to the “specialist”, and most reported little or no improvement.
DR. STEFANOU Are most of the patients you’ve been treating current patients or new patients who have heard about the new treatment option in your practice?
DR. DANNA At this time, all of the patients we are treating were existing patients. We are just beginning the process of marketing to the general public and starting to implement a program to network with medical doctors so that they can experience firsthand how the program works.
DR. STEFANOU Can you give us an example of what treatment consists of once you are able to measure and diagnose using the TruDenta system?
DR. DANNA Once the diagnosis is made to determine the level of treatment needed, the patients go through a series of 8-12 therapy sessions, with 3-4 sessions to make adjustments to balance the occlusion. At the initial visit they also receive a home care kit. The home care routine is essential to the success of the program. The most compliant patients with home therapy see the most profound results. Depending on the level of treatment, some patients also receive a TruDenta SCS system for daily use to help control stress and develop new brain pathways as we break the pain cycle through the therapy modalities. All patients, regardless of level of treatment, are fitted for a rehabilitation orthotic worn through the entire course of treatment nightly. Some patients may need a stabilizing splint following the treatment. Once the main course of treatment is complete, patients return once a month, or as they feel necessary, for maintenance therapy.
DR. STEFANOU What kind of training, certification and other assistance did you receive?
DR. DANNA Training consists of a multi-phased program including: E-Learning, instruction modules, and a two-day, high-intensity classroom instruction at a west or east coast university setting for which I, my RDA and my RDH each received 15 hours of CE credit. (UNLV or NOVA SE University in Fort Lauderdale.) There is ongoingsupport and marketing assistance available. The company works with offices to create referral relationships with their local medical professionals. The company also does advertising and marketing direct to consumers (i.e. USA Today ads).
DR. STEFANOU This technology is a financial investment of more than $70,000. Approximately how much income do you hope to generate?
DR. DANNA We currently generate between $3500 and $5000 per patient. As we begin to establish my practice as the local provider of this advanced technology, the income potential is significant. The most important thing, however, is that we’re now able to provide a solution for so many people who thought they’d run out of options.
DR. STEFANOU One of the questions our colleagues always ask when introduced to a “high tech” innovative system like this is what sort of a ROI should they expect from their investment. How profitable can this system be for most dental offices, and how many patients would need to be treated monthly to see a solid ROI?
DR. DANNA While this certainly is not an inexpensive program to implement, I firmly believe I will see well over 100% ROI within the first year. Bringing four new patients a month into the program will provide a rock solid ROI. The system works because the patients can see tangible results from the very first appointment. The profitability is limited only to the amount of effort put in by the dentist and team. Learning to talk about it with EVERY patient is important because while the patient you are currently seeing might not be affected, the chances are good that they know someone who is!
DR. STEFANOU What kind of marketing or community awareness activities are you utilizing to educate potential patients about the treatment you’re providing that sets you apart from other dental practices?
DR. DANNA We began our marketing efforts with press releases, with details on our website, social media outlets and our blog as well as traditional mailings. We are currently working with several of the large corporate HR departments in our county to introduce the system through health fairs and other speaking engagements.
DR. STEFANOU How gratifying has it been for you to have a system like this in your practice?
DR. DANNA I have been in General Dentistry for 17 years and I love what I do. It is so gratifying to be able to provide a service to the community where there has been little resolution of the underlying problem; only management of the symptoms. To see patients getting their lives back and being able to enjoy their families and be more productive at work has been incredible. The added financial rewards of the program has helped increase cash flow, allowing me the opportunity to, in turn, invest in and provide other new services to my patients.
DR. STEFANOU How do patients pay for the TruDenta care you provide?
DR. DANNA Patients typically pay in a traditional fee for service model, however the care is covered by certain medical insurance policies and can be financed by companies such as CareCredit.
DR. STEFANOU What final thoughts would you like to leave other dentists with as we conclude?
DR. DANNA This is a system that can significantly impact your bottom line. A word of caution, however; you must have a team that understands the benefits to the patients and works collaboratively to introduce the system enthusiastically and consistently. In order to provide treatment benefits to current patients and new patients (friends, family and colleagues), everyone from the front desk to the entire clinical team must be on board! This type of technology has the potential to change the way we practice and broadens the services we provide to a wider range of patients.
In many cases, only dental professionals can help the estimated 80 million Americans suffering from the painful symptoms caused by improper dental forces, called dentomandibular sensorimotor dysfunction (DMSD).
READ MORE "...it is imperative to include the training for orofacial pain, particularly those from temporomandibular joint and musculoligamentous tissues.” JADA Cover Story, 10/2015, Vol. 146, Issue 10, Pg. 721-728
20% of your existing patients suffer from DMSD, as do 20% of all Americans. Your team members quickly assess patients for "red flags" (which indicate DMSD), utilizing TruDenta's patented technologies.
The National Institutes of Health estimate that over 80 million Americans suffer from one or more of the symptoms of DMSD, including:
• Chronic Headache
TruDenta uses digital force measurement technology, powered by Tekscan®, for evaluating the amount of bite force that is present during closure, at closure, and while chewing. The technology is so advanced that it actually calculates the bite force and motion on a tooth-by-tooth basis. This digital exam literally shows a movie of the bite force in action revealing abnormal forces in the nerves, muscles and ligaments that are often the cause of symptoms.
Bite balance is also calculated to identify potential issues within the overall chewing system. READ MORE
A normal opening for an adult is 53 mm to 57 mm. Limited or restricted range of motion (less than 40 mm) is a reduction in an individual’s ability for normal range of movement. Along with opening movement, an individual should be able to slide their jaw to the left and to the right at least 25 percent of their total mouth opening in a symmetrical fashion.
When restricted movement exists, an imbalance in the system is present, and breakdown of the system is likely to occur. READ MORE
The TruDentaROM is a system of hardware and software that digitally measures cervical range of motion (ROM) impairment based upon AMA guidelines. This directly affects the proprioceptive feedback system of the dental occlusion, TMJ, and the muscles of mastication.
ROM impairment is another “red flag” which assists doctors in accurately diagnosing symptoms that are often dental force related. This data enhances medical insurance collections and the collaboration with referring medical doctors. READ MORE
A typical case requires less than one hour of doctor time in the diagnosis and minor occlusal adjustments during the rehabilitation period.
Treatments are performed by a trained team member once per week, in less than one hour. The most severe cases require 12 treatments. Therapies are spa-like, non-invasive and require no drugs or needles. Most patients report dramatic results after the very fist treatment. Note: The majority of patients utilize an orthotic only during the treatment period, up to a maximum of 12 weeks. READ MORE
The goal of therapeutic ultrasound treatment is to return circulation to sore, strained muscles through increased blood flow and heat. Another goal is to break up scar tissue and deep adhesions through sound waves.
Therapeutic exposure to ultrasound reduces trigger point sensitivity and has been indicated as a useful clinical tool for managing myofacial pain. Additionally, ultrasound also has been shown to evoke antinociceptive effects on trigger points. READ MORE
Sub-threshold microcurrent stimula¬tion reduces muscle spasm and referral pain through low electrical signal. It also decreases lactic acid build-up and encourages healthy nerve stimulation. In particular, microcurrent electrotherapy has been shown to help increase mouth opening significantly.
• Reduces muscle spasm and referral pain through low electrical signal
• Decreases lactic acid build-up
• Encourages healthy nerve stimulation
• Increases mouth opening significantly
Low level laser/light therapy is one of the most widely used treatments in sports medicine to provide pain relief and rehabilitation of injuries. Over 200 randomized clinical trials have been published on low level laser therapy, half of which are on pain.
Low level laser/light therapy decreases pain and inflammation, accelerates healing of muscle and joint tissue 25 to 35 percent faster than without treatment, and reconnects neurological pathways of nerves to the brain stem, thereby inhibiting pain. READ MORE