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to Dental Practice Solutions

Welcome to dentistry’s largest dental hygiene practice management resource center! We are the leading dental hygiene consultant/coaching business.

We will increase your TOTAL dental practice profitability without working more hours or days each year.

- Debbie Seidel-Bittke, RDH, BS, Speaker, Author. Dental Hygiene Coach & Consultant

Dental Practice Solutions - Debbie Bittke

Here is What Happened When I Told My Patients They Have Periodontal Disease

By: Debbie Seidel-Bittke, RDH, BS

January 28, 2016

As a hygienist you see patients probably daily who have perio.

What do you say?

I remember years ago when I was a new hygienist and new to an office as their hygienist, the patients would call back to ask, “why did the new hygienist today tell me that I have this periodontal disease? Why now? Why didn’t they tell me this before?!”

Well, lucky for me, the dentist I worked for called a meeting and we discussed it. Why was “I” – the new hygienist to the office, the one to tell the patients they had periodontal disease? Did this periodontal disease all of a sudden occur?

The answer……..No!

When we talked as a team, the other hygienist said that she did not tell the patients they had perio because she felt sorry for them.

Why did she feel sorry for the patients? Her answer: She felt sorry for them because she thought their insurance would  not pay for all the necessary treatment and she thought it would be a lot of money out of their pocket to get the treatment.

Why do you decide to withhold the information from your patients?

Do you know your patients have periodontal disease?

Do you tell your patients they have periodontal disease?

The American Academy of Periodontology in 2012 and a CDC study also found an even higher prevalence of periodontitis in men (56% versus 38% for women), non-Hispanic Black and Mexican-Americans (58% and nearly 67% respectively). The AAP states that over 30% of Adult Americans have periodontal disease. See The Research Click Here.

Could a few of these people in the study be patients in your dental office?

Here is how you can tell your patients they have periodontal disease without upsetting them.

Here are some tips to say what is really happening in their mouth without them leaving upset and going to another dental office:

1. Listen to your patients (Sit knee-to-knee and eye-to-eye)

2. Build and re-establish rapport with your patients every time they come to your office

3. “Partner” with your patients versus telling them what you “found in their mouth”

4. Explain you will be doing a few assessments to look for any “abnormalities”

5. Explain you will use a small ruler to measure around their gums

– – Tell them they will hear you call out (Have someone come to write the numbers you call out from the perio exam) numbers and 1-3 means healthy gums. Let them know that if they hear a 4 this means there is inflammation and anything 5 or higher means there is infection. And ask them to tell you the lowest and highest number they hear you call out. Use words your patients understand. Know what words they understand. Do they understand what periodontal disease is? Or would they understand better if you said “Gum Disease?”

6. When you are finished with your assessments use the intra-oral camera to take photos of what you see.

– – Show patients what you see on the x-rays and their perio chart. Use brochures, diagrams and charts to explain what you and the patient see in their mouth. Show them the intra-oral pictures you have taken

7. You and your patient;“Together,” create the plan for optimal health

8. Talk about not only creating a healthy mouth, but a healthy body.

– -Share with your patients the research and science about the oral/systemic connection

9. Listen to your patients questions and make sure you break it down into the words they understand

10. Let your patients know how much you care about their total health.

You probably want to know what happened to the patients at the office where I was a hygienist. Did they get angry and go to another dental office because I told them they have periodontal disease?

No, they did not leave. Well, maybe some did leave but not because I told them they had periodontal disease. People leave for other reasons not because they did not like your diagnosis. I think you understand.

Did some call back to complain about me telling them they had periodontal disease?

Not after we had a team meeting to discuss the plan.

And btw: The other hygienist????? She stopped worrying about the patient’s wallet. She stopped feeling sorry for them that they have to come back or pay money.

Our plan was that our doctor said the same thing to the patients about their perio. He supported the hygienist’s conversation to the patients about treating their disease. Some patients did question: WHY Perio Now? Our doctor talked to them and what did I do to calm the patients who came in routinely and now had perio?

After many of my patient appointments that first year as their hygienist, I began calling them back to see how they were doing after their 1st perio therapy appointment. I wrote a special note those routine patients (And I think I even wrote notes to the new patients) telling them how much I enjoy being their hygienist. I started to get to know them at a more personal level.

I showed these patients that I really care about them NOT just their teeth. I called them back to see how they were doing after their 1st perio therapy appointment. I wrote those routine patients (And I think I even wrote notes to the new patients) telling them how much I enjoy being their hygienist. I started to get to know them at a more personal level. I showed these patients that I really care about them NOT just their teeth.

We bought these beautiful note cards and I sent them to my patients. They really thought that was special to get a card from their hygienist.

No longer did patients think we were telling them they have this disease and it was only to bring more money into the office.

No, the patients felt like we cared.

After many of my patient appointments that first year as their hygienist, I began calling them back to see how they were doing after their 1st perio therapy appointment. I wrote a special note to those routine patients (And I think I even wrote notes to the new patients) telling them how much I enjoy being their hygienist. I started to get to know them on a more personal level. I showed these patients that I really care about them NOT just their teeth.

We bought these beautiful note cards and I sent them to my patients. They really thought that was special to get a card from their hygienist.

No longer did patients think we were telling them they have this disease and it was only to bring more money into the office.

What happened to the dentist? Well, sad story but he has melanoma and had to sell the practice.

And yes, a large majority of those patients are still coming back to the office probably because the entire team (Minus me) still work at the office.

I hope this true story of my first years as a hygienist will help you in your journey telling patients the truth, telling them they have periodontal disease.

And one last thought….if your patient has an oral lesion, something suspicious inside their mouth, would you be afraid to tell them because they would get angry? What IF they did go and get a second opinion at another dental office about the bump you found today in their cheek?

Do you think they will leave forever? Probaby not. I bet they come to their office because that is where they feel comfortable, they have a relationship with all of you. And if they do go to another office, I imagine they will come back to your office.

Please do comment and tell us about your office challenge telling patients they have perio disease. What is happening in your office when you tell patients they have periodontal disease?

Here is What Happened When I Told My Patients They Have Periodontal Disease

By: Debbie Seidel-Bittke, RDH, BS

No Hygienist and patient eye to eye

As a hygienist you see patients probably daily who have perio.

What do you say?

I remember years ago when I was a new hygienist and new to an office as their hygienist, the patients would call back to ask, “why did the new hygienist today tell me that I have this periodontal disease? Why now? Why didn’t they tell me this before?!”

Well, lucky for me, the dentist I worked for called a meeting and we discussed it. Why was “I” – the new hygienist to the office, the one to tell the patients they had periodontal disease? Did this periodontal disease all of a sudden occur?

The answer……..No!

When we talked as a team, the other hygienist said that she did not tell the patients they had perio because she felt sorry for them.

Why did she feel sorry for the patients? Her answer: She felt sorry for them because she thought their insurance would  not pay for all the necessary treatment and she thought it would be a lot of money out of their pocket to get the treatment.

Why do you decide to withhold the information from your patients?

Do you know your patients have periodontal disease?

Do you tell your patients they have periodontal disease?

The American Academy of Periodontology in 2012 and a CDC study also found an even higher prevalence of periodontitis in men (56% versus 38% for women), non-Hispanic Black and Mexican-Americans (58% and nearly 67% respectively). The AAP states that over 30% of Adult Americans have periodontal disease. See The Research Click Here.

Could a few of these people in the study be patients in your dental office?

Here is how you can tell your patients they have periodontal disease without upsetting them.

Here are some tips to say what is really happening in their mouth without them leaving upset and going to another dental office:

1. Listen to your patients (Sit knee-to-knee and eye-to-eye)

2. Build and re-establish rapport with your patients every time they come to your office

3. “Partner” with your patients versus telling them what you “found in their mouth”

4. Explain you will be doing a few assessments to look for any “abnormalities”

5. Explain you will use a small ruler to measure around their gums

– – Tell them they will hear you call out (Have someone come to write the numbers you call out from the perio exam) numbers and 1-3 means healthy gums. Let them know that if they hear a 4 this means there is inflammation and anything 5 or higher means there is infection. And ask them to tell you the lowest and highest number they hear you call out. Use words your patients understand. Know what words they understand. Do they understand what periodontal disease is? Or would they understand better if you said “Gum Disease?”

6. When you are finished with your assessments use the intra-oral camera to take photos of what you see.

– – Show patients what you see on the x-rays and their perio chart. Use brochures, diagrams and charts to explain what you and the patient see in their mouth. Show them the intra-oral pictures you have taken

7. You and your patient;“Together,” create the plan for optimal health

8. Talk about not only creating a healthy mouth, but a healthy body.

– -Share with your patients the research and science about the oral/systemic connection

9. Listen to your patients questions and make sure you break it down into the words they understand

10. Let your patients know how much you care about their total health.

You probably want to know what happened to the patients at the office where I was a hygienist. Did they get angry and go to another dental office because I told them they have periodontal disease?

No, they did not leave. Well, maybe some did leave but not because I told them they had periodontal disease. People leave for other reasons not because they did not like your diagnosis. I think you understand.

Did some call back to complain about me telling them they had periodontal disease?

Not after we had a team meeting to discuss the plan.

And btw: The other hygienist????? She stopped worrying about the patient’s wallet. She stopped feeling sorry for them that they have to come back or pay money.

Our plan was that our doctor said the same thing to the patients about their perio. He supported the hygienist’s conversation to the patients about treating their disease. Some patients did question: WHY Perio Now? Our doctor talked to them and what did I do to calm the patients who came in routinely and now had perio?

After many of my patient appointments that first year as their hygienist, I began calling them back to see how they were doing after their 1st perio therapy appointment. I wrote a special note those routine patients (And I think I even wrote notes to the new patients) telling them how much I enjoy being their hygienist. I started to get to know them at a more personal level.

I showed these patients that I really care about them NOT just their teeth. I called them back to see how they were doing after their 1st perio therapy appointment. I wrote those routine patients (And I think I even wrote notes to the new patients) telling them how much I enjoy being their hygienist. I started to get to know them at a more personal level. I showed these patients that I really care about them NOT just their teeth.

We bought these beautiful note cards and I sent them to my patients. They really thought that was special to get a card from their hygienist.

No longer did patients think we were telling them they have this disease and it was only to bring more money into the office.

No, the patients felt like we cared.

After many of my patient appointments that first year as their hygienist, I began calling them back to see how they were doing after their 1st perio therapy appointment. I wrote a special note to those routine patients (And I think I even wrote notes to the new patients) telling them how much I enjoy being their hygienist. I started to get to know them on a more personal level. I showed these patients that I really care about them NOT just their teeth.

We bought these beautiful note cards and I sent them to my patients. They really thought that was special to get a card from their hygienist.

No longer did patients think we were telling them they have this disease and it was only to bring more money into the office.

What happened to the dentist? Well, sad story but he has melanoma and had to sell the practice.

And yes, a large majority of those patients are still coming back to the office probably because the entire team (Minus me) still work at the office.

I hope this true story of my first years as a hygienist will help you in your journey telling patients the truth, telling them they have periodontal disease.

And one last thought….if your patient has an oral lesion, something suspicious inside their mouth, would you be afraid to tell them because they would get angry? What IF they did go and get a second opinion at another dental office about the bump you found today in their cheek?

Do you think they will leave forever? Probaby not. I bet they come to their office because that is where they feel comfortable, they have a relationship with all of you. And if they do go to another office, I imagine they will come back to your office.

Please do comment and tell us about your office challenge telling patients they have perio disease. What is happening in your office when you tell patients they have periodontal disease?

Be sure to check out Hygiene Empowerment. CLICK HERE TO READ MORE

Lead Pages picABOUT DEBBIE SEIDEL-BITTKE, RDH, BS

In 1984 Debbie Graduated from the University of Southern California with a bachelor’s degree in dental hygiene.

She is also a former clinical assistant from the University of Southern California and co-taught the senior dental students Practice Management course until the school went to a PBL learning format.

In 2000, she founded Dental Practice Solutions and works with dental practices world-wide to:

  • create profitable and sustainable dental hygiene departments
  • known for reactivating and retaining patients for dental practices world-wide
  • organically grow new patient numbers

Dental Practice Solutions creates:

  • sustainable dental hygiene departments throughout the world
  • a “team-driven” practice, where the employees feel like leaders vs. employees

All of this means that the doctor can come to the office to do their job as a Dentist and not worry about managing people!

 

Do You Fear Your Patients Will Go To Another Office If You Tell Them…?

By: Debbie Seidel-Bittke, RDH, BS

January 20, 2016

[video_player type=”embed” width=”560″ height=”315″ align=”center” margin_top=”0″ margin_bottom=”20″]PGlmcmFtZSB3aWR0aD0iNTYwIiBoZWlnaHQ9IjMxNSIgc3JjPSJodHRwczovL3d3dy55b3V0dWJlLmNvbS9lbWJlZC8xOU1mU2tyTlI5WSIgZnJhbWVib3JkZXI9IjAiIGFsbG93ZnVsbHNjcmVlbj0iIj48L2lmcmFtZT4=[/video_player]

The above video is from a November 2015 VLOG.

It’s an epidemic in offices that we talk to almost weekly.

Do You Fear Your Patients Will Go To Another Office If You Tell Them They Have Periodontal Disease?

Here is how you can begin to eliminate the worry:

  • Establish rapport.

This is created during the first 90 seconds when you seat your patient in your dental chair.

“People don’t care how much you know but they care about how much you CARE about them.”

Sitting down to chat a few minutes before you lay a patient back in the chair will make or break your time with the patient.

Trust is the #1 reason patients will say “YES” to your care and return consistently and indefinitely to your office.

  • Explain to patients before you lay them back what you will be doing for them today.

Example: “Today, I will be completing a few “Abnormality screenings.” The first one is to ___________ and then I will take a ruler and measure around your gums…(show them what the probe- “Ruler” looks like), continue your explanation of what you are doing when you lay them back in the chair. Explain about the numbers you will call out mean. And ask your patient to listen and tell you what they hear.

  • Have another team member chart during a comprehensive perio exam so the patient can hear the hygienist call out the numbers.

Bring your patient into collaboration.

  • When you do discover an abnormality, sit your patient upright in the chair. It is very possible that if you have elegantly and effectively communicated to your patient, now they are telling you what they heard and they are telling you they heard things don’t seem healthy.
  • Show patients what you see and allow them to “Discover” any abnormalities with you.

Show patients the bone loss and calculus on radiographs. Show patients areas of decay. Use the intraoral camera and take pictures and then review what you see in the pictures with the patient. Always take before and after photos if your patient had positive change in their oral health. Use brochures and diagrams to show patients what is happening in their mouth and body.

Talk about the oral and systemic health connection and always tell your patients that having a healthy mouth will mean living a longer healthier life.

If you want to dive deeper into this topic please schedule a complimentary call to see how we can support your hygiene department. Click the link to schedule 30 minutes with Debbie. SCHEDULE 30 MINUTES

Lead Pages picABOUT DEBBIE SEIDEL-BITTKE, RDH, BS

Debbie is founder of Dental Practice Solutions and supports dental practices throughout the world to have more profitable and sustainable hygiene departments. This is done by empowering hygienists to take a leadership role in their professional place.

Please check out the Hygiene Empowerment 6 Month Coaching to see how this works. You can also click the link shown above in the blog to schedule a time to discuss your dental practice.

Debbie is also a former clinical assistant from the University of Southern California and co-taught the senior dental students Practice Management course until the school went to a PBL learning format.

In 2000, she founded Dental Practice Solutions and works with dental practices world-wide to:

  • create profitable and sustainable dental hygiene departments
  • known for reactivating and retaining patients for dental practices world-wide
  • organically grow new patient numbers

Dental Practice Solutions creates:

  • sustainable dental hygiene departments throughout the world
  • a “team-driven” practice, where the employees feel like leaders vs. employees

All of this means that the doctor can come to the office to do their job as a Dentist and not worry about managing people!

Do You Fear Your Patients Will Go To Another Office If You Tell Them…?

By: Debbie Seidel-Bittke, RDH, BS

[video_player type=”embed” width=”560″ height=”315″ align=”center” margin_top=”0″ margin_bottom=”20″]PGlmcmFtZSB3aWR0aD0iNTYwIiBoZWlnaHQ9IjMxNSIgc3JjPSJodHRwczovL3d3dy55b3V0dWJlLmNvbS9lbWJlZC8xOU1mU2tyTlI5WSIgZnJhbWVib3JkZXI9IjAiIGFsbG93ZnVsbHNjcmVlbj0iIj48L2lmcmFtZT4=[/video_player]

The above video is from a November 2015 VLOG.

It’s an epidemic in offices that we talk to almost weekly.

Do You Fear Your Patients Will Go To Another Office If You Tell Them They Have Periodontal Disease?

Here is how you can begin to eliminate the worry:

  • Establish rapport.

This is created during the first 90 seconds when you seat your patient in your dental chair.

“People don’t care how much you know but they care about how much you CARE about them.”

Sitting down to chat a few minutes before you lay a patient back in the chair will make or break your time with the patient.

Trust is the #1 reason patients will say “YES” to your care and return consistently and indefinitely to your office.

  • Explain to patients before you lay them back what you will be doing for them today.

Example: “Today, I will be completing a few “Abnormality screenings.” The first one is to ___________ and then I will take a ruler and measure around your gums…(show them what the probe- “Ruler” looks like), continue your explanation of what you are doing when you lay them back in the chair. Explain about the numbers you will call out mean. And ask your patient to listen and tell you what they hear.

  • Have another team member chart during a comprehensive perio exam so the patient can hear the hygienist call out the numbers.

Bring your patient into collaboration.

  • When you do discover an abnormality, sit your patient upright in the chair. It is very possible that if you have elegantly and effectively communicated to your patient, now they are telling you what they heard and they are telling you they heard things don’t seem healthy.
  • Show patients what you see and allow them to “Discover” any abnormalities with you.

Show patients the bone loss and calculus on radiographs. Show patients areas of decay. Use the intraoral camera and take pictures and then review what you see in the pictures with the patient. Always take before and after photos if your patient had positive change in their oral health. Use brochures and diagrams to show patients what is happening in their mouth and body.

Talk about the oral and systemic health connection and always tell your patients that having a healthy mouth will mean living a longer healthier life.

If you want to dive deeper into this topic please schedule a complimentary call to see how we can support your hygiene department. Click the link to schedule 30 minutes with Debbie. SCHEDULE 30 MINUTES

Are Your Dental Patients Are At Risk for Caries?

By: Debbie Seidel-Bittke, RDH, BS

January 7, 2016

[video_player type=”embed” width=”560″ height=”315″ align=”center” margin_top=”0″ margin_bottom=”20″]PGlmcmFtZSB3aWR0aD0iNTYwIiBoZWlnaHQ9IjMxNSIgc3JjPSJodHRwczovL3d3dy55b3V0dWJlLmNvbS9lbWJlZC8zRkRlSXgtT2dhdyIgZnJhbWVib3JkZXI9IjAiIGFsbG93ZnVsbHNjcmVlbj0iIj48L2lmcmFtZT4=[/video_player]

How many patients each day does your hygienist or if you are the hygienist, how many patients each day do you discuss this topic with?

Who do you believe needs to have caries prevention services such as fluoride varnish place?

Are your patients at risk for caries?

 

Who are patients you want to recommend flurride varnish for?

Most pediatric patients are excellent candidates for fluoride varnish treatments at least twice a year. Fluoride Varnish has the highest efficacy, it can also help to re-calcify enamel or incipient decay, it’s easy for you to

apply, children are less likely to swallow the varnish and it goes on so quickly without the patient having to sit with these uncomfortable foam trays in their

For patients at moderate risk for caries, it is recommended that you provide this patient with a fluoride varnish treatment and they are sent home with 5 mgs sodium fluoride tooth paste to use each night

at bedtime.

The frequency of periodic oral exams is increased and radiographic evaluation with new bitewing radiographs may be desirable every six to 12 months. A moderate-risk patient in general terms is one

who has some risk factors identified and whose caries balance could likely be moved easily to high risk.

Patients who have moderate or high-risk for decay need additional fluoride therapy. 50 mg Sodium Fluoride, could be added to ensure that the balance is tipped toward arresting the progression of the disease. Moderate

risk patients will include people with caries lesions in the last 18 months, patients with xerostomia, ortho patients and patients who exhibit localized areas of 2 mms or greater recession abractions and especially geriatric

patients with recession and those patients who take various medications which means that xerostomia is most likely since this is the #1 side affect for thousands of medications.

Always check the latest CAMBRA recommendations and the CDT Codes for billing which changes annually. AND Be sure to always offer your patients the highest level of care – Which excludes finances

being a reason to not recommend treatment. Always provide your patients various flexible financial options.

You can look at various resources online for example the CA dental Journal in 2011

CLICK THIS LINK FOR THE CA DENTAL JOURNAL CAMBRA ARTICLE

Are Your Dental Patients Are At Risk for Caries?

By: Debbie Seidel-Bittke, RDH, BS

[video_player type=”embed” width=”560″ height=”315″ align=”center” margin_top=”0″ margin_bottom=”20″]PGlmcmFtZSB3aWR0aD0iNTYwIiBoZWlnaHQ9IjMxNSIgc3JjPSJodHRwczovL3d3dy55b3V0dWJlLmNvbS9lbWJlZC8zRkRlSXgtT2dhdyIgZnJhbWVib3JkZXI9IjAiIGFsbG93ZnVsbHNjcmVlbj0iIj48L2lmcmFtZT4=[/video_player]

How many patients each day does your hygienist or if you are the hygienist, how many patients each day do you discuss this topic with?

Who do you believe needs to have caries prevention services such as fluoride varnish place?

Are your patients at risk for caries?

 

Who are patients you want to recommend flurride varnish for?

Most pediatric patients are excellent candidates for fluoride varnish treatments at least twice a year. Fluoride Varnish has the highest efficacy, it can also help to re-calcify enamel or incipient decay, it’s easy for you to

apply, children are less likely to swallow the varnish and it goes on so quickly without the patient having to sit with these uncomfortable foam trays in their

For patients at moderate risk for caries, it is recommended that you provide this patient with a fluoride varnish treatment and they are sent home with 5 mgs sodium fluoride tooth paste to use each night

at bedtime.

The frequency of periodic oral exams is increased and radiographic evaluation with new bitewing radiographs may be desirable every six to 12 months. A moderate-risk patient in general terms is one

who has some risk factors identified and whose caries balance could likely be moved easily to high risk.

Patients who have moderate or high-risk for decay need additional fluoride therapy. 50 mg Sodium Fluoride, could be added to ensure that the balance is tipped toward arresting the progression of the disease. Moderate

risk patients will include people with caries lesions in the last 18 months, patients with xerostomia, ortho patients and patients who exhibit localized areas of 2 mms or greater recession abractions and especially geriatric

patients with recession and those patients who take various medications which means that xerostomia is most likely since this is the #1 side affect for thousands of medications.

Always check the latest CAMBRA recommendations and the CDT Codes for billing which changes annually. AND Be sure to always offer your patients the highest level of care – Which excludes finances

being a reason to not recommend treatment. Always provide your patients various flexible financial options.

You can look at various resources online for example the CA dental Journal in 2011

CLICK THIS LINK FOR THE CA DENTAL JOURNAL CAMBRA ARTICLE


Lead Pages pic ABOUT DEBBIE SEIDEL-BITTKE, RDH, BS

Debbie is founder of Dental Practice Solutions and is known for the past 11 years as one of dentistry’s leaders in consulting. She started Dental Practice Solutions in 2000. Debbie is a previous clinical hygienist as well as a former program director where she wrote the accreditation and started the hygiene program in Portland, Oregon.

Debbie spent many years at the University of Southern California as a clinical assistant professor guiding the senior hygiene department students in advanced clinical skills as well as she co-taught the senior dental students practice management.

You will read her published articles frequently is various dental journals and see her speak at most of the national dental conferences. Be sure you enroll in her introduction to Hygiene Empowerment where she empowers hygienists to lead the hygiene department and create a profitable dental practice. Click Here to Enroll in the Introduction.