Dr. James Downs, DMD, practices restorative and cosmetic dentistry with his wife, Dr. Nickie K. Lê, DDS, in Denver, Colorado. He is an educator for the prestigious Dr. Dick Barnes Group and lectures throughout the US and Europe on comprehensive treatment, managing occlusal problems, patient education, case acceptance, and a variety of dental applications. A long-time user of T-Scan™, he sat down with Tekscan at the American Academy of Cosmetic Dentistry (AACD) Annual Meeting last year to explain his journey.

What made you decide to buy T-Scan™?

I bought T-Scan because of three things: it's a piece of technology that's easy to use, it's simple to educate my patients about it, and it gives me information that is documentable.  Documentation today, in this world that we live in, is necessary. Having that insight, that form of knowledge, makes it very easy to implement and then make diagnostic decisions based on the data I have.

Has T-Scan changed the way you think about occlusion?

I have been through so many different continuing education camps, and some have been around over a 100 years. I've seen the progression and evolution of all the camps, and there is promise from everyone of them, yet none of them gave me that clarity of knowing exactly where the occlusal issues were or what caused them.

When the idea of timing versus force came about, that was something we didn’t know in school. We were basing occlusal analysis on subjective thinking. We looked at articulating papermarks and chased the big dots. It's the contrary with T-Scan and a total paradigm shift in occlusion.

In what unique ways are you using T-Scan in your practice?

We use T-Scan in a number of different ways. One that has so far surprised me the most is using it in our hygiene department. Because we see the correlation between pocketing and hyperocclusion. We can identify occlusal contacts that may be contributing to issues. Of course, we use it in full mouth rehabs. When patients make that kind of investment, my philosophy has always been to do it right, do it with excellence. Having that instrumentation, biometrics, and data helps me achieve that. We also use T-Scan in planning, especially with implants and prosthesis. I want those implants to be protected in an occlusal scheme and want my patients to keep their teeth for a long time.

Patients have been impacted the most in my practice. They get it, and they love it! When they see their bite data on the screen, they understand because they correlate the forces on the screen to what they feel in their mouths. They feel so proud when they take a good scan that comes back balanced, because that's what they're feeling, too. They see T-Scan in our practice and ask, "how come other dentists don't have this?" And my answer is that we make an effort to continuously evolve and improve the practice. 

Describe the ways in which T-Scan has impacted your practice.

From a revenue standpoint, you need to understand that T-Scan is not a turn-key revenue generator. It's all about how you use it. We use it anywhere occlusion is concerned, because it's all about case finishing and follow-through. You got to think, "how much is it costing me to remake something?" It costs me time, chair time, patient time, and the lab time. If I lost an implant because I didn't know the true force and timing of that implant in the occlusal scheme, I lose the profitability on the last three cases. That's impactful.

From a prevention standpoint, it can help me identify problems before they escalate. I use a car analogy. What makes the car roll? Tires. If someone kept turning left all the time, they're going to wear that down and may not know the damage being done until it's too late. They have a blowout. When I relate this back to dentistry, how are you going to know if someone is constantly skidding off to the left or right? You don't. Until something in the system goes. T-Scan is a no-brainer in that it helps me see things that could have a long-term impact. I can address it and have the patient address it. In that way, it builds confidence and credibility in our practice.

What would you say to dentists who haven't adopted this technology?

I speak on this topic a lot. And I talk to a lot of dentists about it. Doctors get hung up on the cost. If you know, in your heart, that you can have a piece of technology that can make or break your cases, there should be no question. If you're a doctor who is not going to use it, you need to ask yourself, "why?" 

Think about what you would want for your own dental work, your mother's or father's. How would you want the case done and know for sure it was done properly? If dentists can't pull the trigger, then there's something else in the line of fire. Either they're undereducated about the potential, or don't know the true numbers in their practice. I try to show the value in T-Scan: it's an innovative piece of equipment to add to the practice, and it will certainly propel their practice into the next decade. To have information and data on your patients' occlusion means you have clarity and knowledge that differentiates you from the old world school of thought. That's the kind of technology I want to invest in.

Dr. Downs recently hosted a webinar "Digital Occlusion for Timing Your Posterior Door Stops" Watch the Webinar

Dr. James C. Downs, DMD received his degree from Tufts University School of Dental Medicine. Since then, he is recognized as a key opinion leader. Dr. Downs is an expert in comprehensive restorative treatment. He currently lectures throughout the US and Europe for the Dr. Dick Barnes Group. In his spare time, he likes to go RVing, fish, golf and spends time with his kids. Dr. Downs went into the field of dentistry to figure out how to help himself. At 16 years old, he was kneed in the jaw during a soccer game. The hit left him unconscious on the field and when he woke, he had two fractures on his jaw and two teeth missing. This trauma slowly deteriorated his other teeth through the years.  He went through many dental continual education courses to be able to find the best way to get his own teeth and bite restored. Dr. Downs is a very empathetic and caring dentist due to the experiences he has been through.

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