PAGD Keystone Explorer Winter 2020

Personally, I think one of the most important parts about dentistry is knowing how to tell the story. That’s a pretty broad and sweeping statement but it’s true. For our marketing, it’s critical that we can effectively share what about our skill sets makes us special. In politics, our profession needs to share what we give back to the community. For our team development, one must be able to demonstrate and teach the processes that lead to excellence. And most critically, we must be experts at the capture and explanation of clinical information to our patients that leads to treatment and improvement of the oral condition. For this last reason, we dentists pursue and purchase many different categories of tools and equipment to enhance our abilities to diagnose, qualify, and quantify our patients’ situations. To me, the single most important diagnostic equipment in your office is your X-ray system. This includes a capture medium such as film, phosphor plates, or a sensor, and a radiographic source. In my office, I was first introduced to the Nomad in a time of disappointment when the old tube head in the practice I bought died. Admittedly, it was 35 years old and was probably emitting a shockwave every time it fired before it died but nonetheless needed replacement. Since I had a five-op office and the previous tube head only serviced two, I first debated whether to invest in multiple tubes and the corresponding construction to retrofit the building. Since that cost and process didn’t seem ideal, I looked for a mobile solution and found the Nomad Pro 2 from Aribex (KavoKerr). This device is a relatively light-weight (6lbs) portable tube head with a built-in scatter radiation shield. It can be paired with a laptop and sensor to turn any room into a limited exam space. When I first purchased it, the batteries functioned well and would last all day. The only problem I encountered was that when we went on holiday break, they had a bad habit of not holding charge. The newer version of the batteries actually has a hibernation function that can be reset quickly with the charge station so that you don’t have that down time. It has a simple and easy to use display and labeling that will allow anyone who has passed the simple training course and understands how to point and shoot to take high quality radiographs. For my team, the freedom and ease with which they can help in the diagnosis process has made it one of their favorite practice upgrades. They vastly prefer using the Nomad to the wall mounted tube heads because there is no mobility limitation. While I haven’t had any problems whatsoever in the two years since we have had the Nomad, the care and repair process is also important. They have a program for calibration and repair in which you apply for a temporary working replacement, but they are not always quick to oblige. My belief is that since the manufacturing lead time is several months and they are so popular, they struggle to keep enough inventory. My recommendation would be to keep your sales rep as a close part of the process so that there is insider follow through. For me, this and my intraoral camera are the two most important diagnostic imaging tools I have. There are higher levels of imaging out there and they are worth learning about and acquiring as well. I haven’t yet made the leap to upgrade my panoramic to a CBCT, but I use the Anatomage Cloud software to instantly and easily receive images from my specialists. I did recently purchase a Primescan and Omnicam from Dentsply Sirona for 3-D/4-D scanning and I love it and use it every day. However, while I do find great utility for CBCT visualization and scanning, quick and easy single X-rays and intraoral photos remain the bedrock of my practice. Ross Dr. Ross Isbell is a general dentist who practices in Gadsden, AL. His primary writing appears in the AGD Impact where he discusses and reviews products in a column called Testing the Tools. Much of the information contained in this article was originally appeared in the January 2019 and November 2020 issues. love letters  From Ross Isbell, DMD Keystone Explorer | Winter 2020 17