Page 66 - CEREC Q3|2013

64 | cerecdoctors.com | quarter 3 | 2013
this argument. Perhaps it’s my age, perhaps it’s my cynicism or
perhaps I’m at a point inmy career where I can choose to invoke
the famous line, from Gone With the Wind, where Rhett Butler
says to Scarlett O’Hara “Frankly my dear, I don’t give a damn!”
Let’s make one thing perfectly clear — Ethics matter. The
clinician with poor ethics will abuse the doctor/patient privi-
lege whether or not they have a CEREC, a cone beam or even
just a simple handpiece in their arsenal. The dentist without a
CEREC and without ethics is the one whose new patients will
magically need 16 occlusal amalgams—every single one of them.
It just so happens that you put a CEREC in this clinician’s hand,
magically all the teeth with “cracks” need crowns.
There is no doubt that legitimate dental disease needs
require legitimate treatment. But lack of ethics will lead a
clinician to remove a perfectly healthy tooth simply to treat-
ment plan an implant, abutment and crown. Lack of ethics will
lead a clinician to crown a tooth with minor occlusal decay,
and lack of ethics will cause a clinician to place preventive
amalgams in the occlusal surface of every single new patient
in their practice.
So let’s all agree that there are people out there whose sole
intention is to game the system, regardless of what the rules say,
regardless of what they have agreed to, regardless of the moral
standards that they should live by. Bad people have as their sole
goal to try to cheat their patients and anyone else they work
with. There is no hope for these people, as they and they alone
have to live by with the results of their actions.
My point in all of this is that CEREC is a good system, and if
used properly and ethically it can provide fantastic treatment
for your patients. Let’s not blame the arrow, let’s take a close
look at the archer and focus on providing the best possible clin-
ical care for our patients.
The technology today is to a point where CAD/CAM, aka
CEREC, is mainstream. You will see more and more clinicians
embracing CAD/CAM. Unfortunately that also means you may
see more unethical clincians — even if it’s a small percentage
of the total.
I’ve met some good people using the CEREC system. They are
some of the best clinicians and best individuals. Unfortunately
I’ve met some at the other end of the honor spectrum as well.
But let’s leave the CEREC and the hammer-and-nail analogy out
of it. An unethical person is just an unethical person—nomatter
what restorative tool they have in their hand.
h a p p e n i n g s i n t h e w o r l d o f c a d / c a m | | | b y s a m e e r p u r i , d . d . s .
as long as i’ve been involved with using the cerec
system to treat my patients, I’ve been involved in discus-
sions with other non-CEREC-owning clinicians regarding the
expense and the ethical concerns of owning the system. With
regard to the ethical concerns, there is the suggestion by some
that if a dentist has a CEREC, then, like a hammer, every tooth
appears as a nail. The crux of the insinuation is simply that
CEREC dentists tend to over-treat their patients because they
have a payment to make for their machine.
Let’s discuss the first issue — the finances. The financial argu-
ment is one that I’ve never bought. Is there an investment to
get into the technology? Absolutely. But there has never been a
new cost to the practice for owning a CEREC. Meaning that if
you already have a lab bill, chances are that most of that lab bill
will be replaced by the things that you can do chairside with the
CEREC. You are already paying for the machine by making your
monthly lab payment.
The 4.2 software is robust in that it allows you to do implant
abutments, permanent chairside one-visit bridges, inlays,
onlays, surgical guides, crowns and more. That’s a lot of nails
that a clinician can treat with their CEREC hammer in their
office. To me, the cost of ownership is simply not an issue with
a typical office, as long as they are doing enough dentistry. Ten
crowns a month is roughly $1,500 (at about $130/unit plus
tax and shipping). Throw in two three-unit bridges at $150 a
unit, and a couple of implant abutments with the lab at $500/
custom abutment plus the cost of the crown. You are already
well over $3,000 for the month in lab fees. With just this little
bit of dentistry, you are already spending more than the monthly
payments for the system. Anything beyond this is savings for the
patients and doctors.
With regard to the ethical concerns mentioned previously,
I’ve come to the point that I absolutely refuse to even engage in
For questions and additional information, Dr. Puri can be
reached at sameer@cerecdoctors.com.
Ethics Matter
Ethics matter. The clinician
with poor ethics will abuse the
doctor/patient privilege whether
or not they have a CEREC or
cone beam or even just a simple
handpiece in their arsenal.