Come to My Window

Paul Feuerstein, DMD


…we are seeing a lot of new digital impression systems coming into the marketplace….from familiar…[and] new manufacturers….

The last quarter of 2019 was very busy with new product introductions as well as an interesting computer issue that will affect every office. This “issue” is Windows 10. As of January 14, prior versions of Windows are not supported. You might think that this is not a big deal; after all, how often do you call Microsoft for Windows support? That is not the big story: They will no longer update the operating system with security enhancements. As you know, there are new malware and ransomware attacks, viruses, etc, that not only make your systems unusable but also expose your data to the outside world. We all have sensitive patient information in our systems. A breach is a HIPAA violation, and the penalties are staggering. Those of you who have not looked at the upgrade to Windows 10 could be in for a big financial surprise. Most of the older computers and workstations cannot be upgraded from, for example, Windows 7 or 8. In the simplest terms, the system requirements are larger, and the processing power is more demanding. I am not saying that it is impossible to run the upgrade, but computers will not run properly if they are not configured or if certain components are not upgraded. This could mean replacing every computer in the office and then reconnecting all of your hardware (digital radiography and intraoral cameras, for example) as well as reinstalling your practice management systems. Some of you might be willing to do it yourself, but just the time involved in reconfiguring even a small office with 3 to 4 treatment rooms, a front desk, an office, a server, etc, is a daunting task. I have been asked to look at some IT company proposals, and they ran from $25,000 to $80,000 in “just a simple GP office.” Take a hard look at what you are running, and do not ignore this as the fines will make that upgrade investment look like, as they say, chump change.

Speaking of computers, I have had a chance to work with some new keyboards and mice that are totally waterproof and disinfectable. There isn’t a very good technique to wipe these down between patients. Offices tend to use things like Saran Wrap or blue sticky barriers, at least on the mice. I was given a couple of wired and wireless units to use in my office, and we did our best (as requested) to try and destroy them. We sprayed them with everything we had and submerged and scrubbed them in the sinks, and they are still working. Check out Man & Machine’s products at

On another front, we are seeing a lot of new digital impression systems coming into the marketplace at initial costs of under $20,000. Some are from familiar companies, while others are from new manufacturers hailing from Denmark, France, Belgium, Korea, China, and more. As I look at each of these systems, my initial thoughts are that they all seem to scan, but you are usually only getting basic scan software or the ability to use a third-party program like Exocad. As said, they all seem to scan (at least based on a typodont that I tried at a trade show) and all are “open,” meaning that you can create a standard file, such as an STL file, that can be used by any laboratory or open software. Many of these will be sold by independent distributors, and others will be sold direct. There are users’ groups for some of these new products online that are either hosted independently or through social media sites, like Facebook. As more practitioners use these products, more peer-to-peer feedback is generated for improvements that the manufacturers and distributors see instantly, and they often implement changes quickly. The larger companies, of course, make changes based upon user feedback, but some of the smaller ones have upper management monitoring and responding directly to the users, thereby speeding up development.

Despite this “competition,” the legacy companies are constantly improving hardware and software and also have thousands of cases that have been done as well as thousands of users giving constant feedback through many channels, including large user meetings. One interesting situation in the marketplace is that Midmark has now taken over the True Definition Scanner (formerly 3M) and is working on improvements that will be introduced shortly. They have been showing the product at the past few meetings.

Finally, a few years ago, I wrote about using buffered local anesthetic with sodium bicarbonate. Many dentists have used this idea in their practices, but it is a bit cumbersome to implement. Two companies, Anutra ( and Onpharma (, have systems that simplify the process. The latter company went through some corporate changes and was off the grid, but it is now back (and, as they say, better than ever) with the original founders running the show. Originally, it was only used with lidocaine; they have now added use with standard carpules of articaine, prilocaine, and mepivacaine. Buffering, if you are unfamiliar, shortens the time it takes for the patient to get numb, leads to a more comfortable injection, and (anecdotal) provides the patient with more profound numbness. There are clinical references and more information on both companies’ websites; they are eye openers if you are unfamiliar with the process.

This month, the Chicago Dental Society’s 155th Midwinter Meeting will take place; historically, many new products have been launched there. I have my running shoes ready for this show and will be reporting on any interesting developments at the show both here and online at

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