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Features / June 1, 2023

Elevating the possibilities of digital dental laboratories

by Tamara Milanovic

Rory McEnhill on his fully digital lab

Tamara Milanovic speaks with Rory McEnhill about his fully digital dental lab, Elevate Dental Designs, and the possibilities that come with embracing digital dentistry.

Tamara Milanovic (TM): How did you get into digital dentistry? 

Rory McEnhill (RM): I started on my digital journey eight years ago. 

I attended a digital smile design course in Croatia with Christian Coachman. This course was an eye opener and highlighted the exciting possibilities for dentists and patients alike. 

Following that, I purchased my first Trios scanner, and the rest is history!

The path to full digital immersion wasn’t a straight line for me. In the beginning, my analogue and implant workflows were refined and quick. So, my staff and I were quite resistant to swap over to digital.

Initially, my intraoral scanning was laboured and inefficient, and it took much longer to achieve the same results that I was achieving with my analogue workflows. Back in the day, the software also wasn’t as intuitive, and there was no support from the wholesalers who had sold me the scanner. 

However, eventually, through persistence and obstinance on my part, my Trios scanner became irreplaceable, and I haven’t looked back since. 

These days, it’s a very different time to be getting involved. There’s a lot more out there – more mentorship and support, especially. It’s never been easier to get involved.

TM: Now, you run a fully digital lab and training business. What motivated you to start Elevate Dental Designs and what does it entail? 

RM: After bringing the digital functionality into the practice, for me, the priority was running a business and assessing where I could make that business more productive. 

The next step was bringing a design service and manufacturing into my practice. So, from that decision, I purchased a milling machine. 

The plan was to do all my clinical work, digital scanning, digital designing and manufacturing. However, I very quickly realised that I had bitten off more than I could chew. 

At that point, with two kids under three, a thriving dental practice and an embryonic digital dental laboratory, 

I realised that there was zero chance that I could excel at being a good father, dentist, and technician at the same time. 

Consequently, I decided to bring a digital technician into the business. 

It took me a while to get somebody into the digital laboratory who could take it and run, and I found that a lot of technicians were analogue and didn’t want to be digital. 

Eventually, I met my business partner, Neil Berkley. He was running a laboratory over in England, and thankfully, married a Northern Irish girl who wanted to move back home. Of course, she brought him over with her as all great Northern Irish girls do! 

We had an initial discussion, and it quickly became clear that he was equally as passionate about digital dentistry as I was. 

Together, we decided to go into business together with the existing digital entity that we had, which comprised my wife, Patricia, who is a business consultant, myself, and Neil. We then renamed the business Elevate Dental Designs. 

When I knew that I had my counterpart in the digital dental laboratory side, we realised we could really start pushing on, so we invested heavily in milling machines, 3D printers, lab scanners etc.

The laboratory was situated in my dental practice, but we outgrew that very quickly. Recently, we have refurbished a larger building and have brought new equipment, and created a training facility for dentists and technicians. 

Our plan is to run multiple courses, whether it be our Signature Smile workflow or an introduction to digital dentistry and 3D printing, but with the view to bring in digital planning and treatment planning. 

For digital technicians, we’re clear that this is where the market is moving, so we’re situating ourselves in a position to avail from this. 

TM: Why are these training opportunities so important for dentists and technicians to take up?

RM: As a dentist, I’m always on the lookout for CPD and new learning opportunities. When dentists go for a course, they’re looking for CPD, but they’re also looking to upskill themselves. They want to go on a course, and be inspired to make a change come Monday morning. 

If there is uncertainty, it’s very easy for dentists to sit back into their comfort zones and say: ‘It was good, but I’m not sure if that’s going to work.’ 

So, we have to run a training course that allows dentists to get hands-on opportunities, ideally seeing live patient demos. Then, come Monday morning, they should have a number that they can call to speak to a technician, and enquire about how to implement this. I think those three aspects are very important when you’re running a course. 

For a couple of the Signature Smile courses that we’ve run in England, I focused quite heavily on the hands-on element, but I also ran a number of patient demonstrations. 

Each day, I did approximately two live Signature Smile patient demos, and dentists were able to see up close what happened, they saw problems happen and how I dealt with those problems in real time. 

When you’re a dentist and you’re talking about digital, you have a chance to be honest and say: ‘Look, stuff happens, but here, you can see the problem in this instance and how easy it was for me to rectify that problem.’ 

That gives dentists a lot of confidence to understand that they could handle those problems if and when they happen. And again, having the phone number to be able to speak to a clinician or dental technician and ask questions is something I feel that is lacking in many courses.

A lot of the courses are just lecture-based, but I don’t think lectures are enough to change dentists’ behaviour. They need the hands-on experience and to see live demos, as well as the support network after.

I feel that Elevate Dental Designs offers that to those clinicians that attend any of the courses the team runs. 

TM: How do you think the lack of training plays into the recruitment issue that we see with technicians? 

RM: In terms of the digital dentistry technician courses, there’s very few formal training programmes available, and anything that’s out there is usually just a day course. The vast majority of digital technicians are self-taught or taught on the job.

We’ve now got five technicians working in the lab, but we had to recruit analogue technicians that have some knowledge in digital workflows and upskill them in-house.

That takes time, and we’ve had to restrict the amount of business we take on because we didn’t want to overwhelm ourselves. Essentially, we work in stages where we assess if we can take on more business, then we plateau while our technicians get trained, and then take on new technicians to increase our ability to service dentistry.

We also want to empower our technicians to identify their weaknesses. We want them to come to us and explain where they want to learn more, so that we can find courses for them to do. 

Also, I feel it’s important to explain that I don’t see any differentiation between a dentist and a technician learning about digital dentistry. 

We’re very happy to send our technicians on digital smile design courses because, even though it’s primarily focused for dentists, there’s so much that can be absorbed by technicians about treatment planning processes, set-up of teeth, and what dentists and patients are interested in. 

What’s changed in recent times is what I call the dental trinity. The whole consultation process involves the patient, dentist and technician from the outset. 

Having those three entities interact at an early stage, having a conversation, finding out what the patient wants, and implementing that into any treatment plan is a vital part of the process.

TM: What else do you feel technicians need to fully embrace digital dentistry? 

RM: First, I think analogue technicians need to stop seeing digital dentistry as a threat and they need to start looking at it as a huge opportunity. I understand that the labs are very busy environments and to enact change to streamlined analogue workflows can seem like a very daunting prospect.

However, with this digital wave that’s about to wash over the dental industry, the question becomes: do analogue labs get washed away and become obsolete? 

I think the benefits of digital adoption will become clear as more digital technician formalised training pathways are available online. Technicians can really broaden their horizons and you’ll then start to see incremental change occur in analogue labs. 

In analogue labs, the workflows are very much process-driven, with technicians carrying out maybe one element of the manufacturing process, akin to an assembly line. This can be very repetitive and uninspiring for technicians. 

With digital workflows, technicians can be involved from the beginning to the end, and it allows them to take charge of the design and the manufacturing aspects of the workflow. This gives technicians a lot of responsibility, and their job satisfaction is going to massively improve. 

Realistically, digital dentistry is the future. But it also is the present, and I think that the sooner people jump on board and come along for the ride, the sooner they’re going to rejoice at that decision. 

Elevate Dental Designs is a proud sponsor of the 2023 Irish Dentistry Awards. Follow the digital dental laboratory on Instagram @elevatedentaldesigns.

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