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?

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

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

There is a lot going on this year and I believe that it is very important to support you to get to your next level of success in 2016.

You may have heard of my training called Hygiene Empowerment and maybe you think that trainings are boring or their are not worth the money so I have a free introductory training to Hygiene Empowerment because you may not  know how much meat is in my training videos. Hygiene Empowerment provides you with Bi-monthly training videos and implementation guide, a transcript of the videos and an action plan to get going on what you learn immediately.

Grab your gift of the free introductory videos which also includes our most popular eBook about treating the bloody prophy and a webinar with 5 Steps for hygienists to discuss treatment plans with patients so doctor comes in at the appropriate time to complete the exam and the patient is all set up to say “YES” to their treatment.

All you need to do is CLICK THIS LINK  and enter you name and email. This costs you nothing but if you do nothing it costs you everything. I want to wish you much success in 2016 and together we can make 2016 your best year ever.

Happy New Year!

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

We find that there are hundreds of patients who did not accept treatment in 2015.

What will happen to that decay that started out as something small? Will they feel motivated to accept treatment if and when they do return to your office in 2016?

What can you do now to give your hygiene patients what they deserve?

Most of us who have a career in dentistry are in this business to help people.

If you are in the business of helping people and yet you don’t want to  “Sell” dentistry, then let’s change that word “Sell” into “SERVE.”

I looked up the definition of SERVE and here is one sentence that will describe this word:

“A person in the service of another.”

I imagine that if you are reading this that you are an excellent clinician. And I want to encourage you to be eager to serve your patients with the very best you have to offer.

Have you checked your end-of-year case acceptance numbers?

You should have close to an 80% case acceptance rate and the majority of your treatment plans should originate from the hygienist having a discussion with the patient, showing them (together) what they see in their mouth.

Yes, that is correct! Both the hygienist and the patient should be looking together and they come up with the perfect plan. Doctor comes in at the appropriate time to complete the hygiene exam and doctor is all set up to agree with what the hygienist and patient have already discussed.

If you have a system like this in place, life will be much easier for everyone and your patients will get the dentistry they deserve!

Do you wish your hygienist would support the treatment planning process more?

Last week I asked thousands of doctors, “What is one thing you wish your hygienist would do more of?”
The answer was: “Help enroll patients into treatment.”

This is why I write about this today and if you want to make this change for your hygienist(s) to enroll more patients then check out Hygiene Empowerment.

Doctors who enroll in Hygiene Empowerment have huge returns from what their hygienist creates in treatment plans, perio therapy and so much more!

Between December 26, 2015 and January 1, 2016, I will host a webinar that you can listen to at your leisure. Be sure to check back so you can get all the information.

Enroll in the Hygiene Empowerment Series at no cost and you will be one of the first to receive the webinar info. CLICK HERE TO GET THE TRAINING NOW

ABOUT 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!

Be sure you check out our Hygiene Empowerment Program. Register here 

Last week I went undercover as a patient to a corporate dental office.

I posed as a “non-dental professional” at a “corporate” or “big box” dental office. Maybe you read last week’s blog and already know about this. Here is what I didn’t tell you last week.

My experience was quite “eye opening”.  This location provided an extremely positive customer experience.  From the minute I walked into that office…to meeting the doctor and then even the hygiene appointment, I was treated extremely well.  This is what you would call Five Star Customer Service.

And Believe Me, I came prepared to be on the defense.  I came prepared with an eagles’ eye on every aspect of this visit.

They weren’t perfect, but what I saw first-hand was the basics of what I work with my clients on to build their practice: (Read last week’s blog for my one complaint)

• The Customer Experience
• Effective Communication (internally and externally)
• Philosophy of patient care
• Philosophy of care for evaluating periodontal disease

One of the many takeaways from this experience is that Corporate Dentistry has many more employee resources at their finger-tips that will keep all of their office locations running at a high level of care.

They have state of the art equipment AND they are using best practices that will enable them to continue to chip away at the very dental offices we work with…the independent dental practice.

The Corporate Dental Offices have oversight from:

• CEO
• CFO
• COO
• Accountants
• Legal teams
• Operations
• Training Departments
• Etc.….

All managing their many dental offices in many different locations at a high level.

In comparison the Independent Dental Office who have oversight from:

• Dentist
• Office Manager
• Scheduling Coordinator
• Insurance Billing

The big missing piece here for the independent practice is obvious. There is no one jn place to help provide a high level of oversight and coaching.

Let me give you an example…you may have experienced this personally:

You decide at the beginning of the year to have a New Year’s Resolution.  You’re going to start going to the gym and work out to get rid of some of that extra weight (the Fat) you put on over the holidays…or maybe you just have gotten a little “soft”.

So you get a gym membership and start going to the gym…all goes okay for a week, maybe two and then…suddenly you get busy doing something else.

LIFE GETS IN THE WAY!

The next thing you know, you haven’t been to the gym in two weeks, then three weeks.  Trying to do this all on your own, you basically stop all of those great intentions, and before you know it, you have totally stopped going.  Bummer.  Huh?

So what would happen if instead of just getting a gym membership, you also hire a personal trainer – a fitness coach?  Now, you have some skin in the game.

Someone is there to help with your new exercise plan, someone to help hold you accountable, someone to let you know when you may need to “Pick-up the Pace” during your fitness routine, someone to call you if you miss a work out.

The chance of success is much greater than trying to do it on your own!

Now you actually get the results you wanted, and you are better off for it!

This is exactly what we do at Dental Practice Solutions!  (Also see www.dentalhygiene.solutions )

We become your personal (Dental Practice) fitness coach.  We work with you to work (out) correctly, we don’t want you to hurt yourself and we make sure you get the fastest results!

The goal is for you to work smarter, not harder and get the most efficiency out of your practice, just like a well-designed exercise plan.

• Do you have a New Year’s Resolution to be your best and not work so hard? What goals do you wish to achieve next year?
• What if you could have an accountability partner and someone to call you when you don’t “Show-up?”
• What is someone was there to measure your success and let you know when you need to pick up the pace to achieve your goal(s)?

Please allow us to help you achieve your goals. Let us show your hygiene department and the entire team, how you can achieve your goals (BIG or small) and not work so hard.

Together we can turn your practice into the practice of your dreams!

Contact us at:  mail://support@dentalpracticesolutions.com

or check out our website at www.DentalPracticeSolutions.com

Enroll in our no charge Hygiene Department Empowerment Videos and more here:  ENROLL HERE

Unfortunately, my amazing dentist and previous employer is in Newport Beach, California and I now live in Portland, Oregon. I don’t plan to be in California until Christmas this year.

What should I do? Of course this is like a major catastrophe for a dental professional and one who takes meticulous care of their teeth!

I called my previous dentist/employer and scheduled an appointment to have a (What I thought would probably be!) crown prepped on December 23rd. But in the meantime, I wanted to show my previous dentist a radiograph of the area I thought was fractured.

Lucky for me; No Pain!  That was good news and I immediately began treating myself with fluoride varnish I have in my bathroom closet; just in case there was decay and I could arrest this or possibly reverse any possible decay.

My husband and I have been watching, especially over the last 2-3 yrs., a lot of corporate dental offices pop up in our neighborhood and this one day about a week ago, we saw a sign outside one of the beautiful corporate dental offices that said, “X-rays, Exam and Cleaning ONLY $39!”

What a deal! And of course I really need to get x-rays and send them to my dentist in Newport Beach, California! So I took down their office number and even went to their website where I could request an appointment.

And this is where I decided I would go “Undercover in Corporate Dentistry.” I decided to lie about my occupation Lying is not something I am good at so I seriously practiced with my girlfriend). I needed to work on this idea with my friends so that I would not blow my cover. As I discussed this with my girlfriend we reviewed what I would say and we role played how I would be someone who was JUST a patient and not a person who knew what went on inside a dental office.

My occupation was “domestic engineer.” What a dream!

Truly believing that I had this fracture and thinking that going to a “Corporate Dental Office “was going to be a scam, I equipped myself to NOT BE OVERSOLD!

And guess what?! This “Belief” and all the “Media Hype” about CORPORATE DENTISTRY turned 180 degrees on me!!!

Here is what you need to know if you are a small dental practice.

And btw: I mean if you are currently producing less than 2 million US Dollars in production annually and even if you have 2 office locations or more; here is what you must know to stay in business in the 21st century!

• Personally respond to all and any request by a phone call and someone who represents your office as highly qualified and speaks English well.

1. • Although I requested an appointment by email, on Monday morning I received a call from a lady at this corporate office who really seemed to care about “Me.”
   • She knew from my email that I was concerned about a “Broken” tooth. That is the information I wrote down in my appointment request.

• Allow patients to click and link and easily complete their patient information prior to their arrival for their 1^st appointment.

The information your patient completes online should be very easy to answer: The patient can click a button and answer easily!  The entire information gathering process online should be about 3 and maybe 5 minutes total!

• Be ready for the new patient to arrive!   The moment I stepped foot in the door, the lady at the front desk, who btw was very nicely dressed (I even commented about how beautiful her necklace was!), well-groomed and called me by name.  I never had to say my name. It was obvious that these people were expecting “ME!”
  • Yes, they made me feel like I was Queen of England right away!  The dentist took me into a private office and asked about me. He seemed just as concerned about my fracture as I was. The doctor explained exactly what they would be doing for me today.  I have to admit, I was shocked that for $39 I was getting a full series of x-rays, a panoramic x-ray, intra-oral photos, a “Cleaning, Oh yes! and a “check of my gums ” (i.e. a full mouth comprehensive perio exam.), and doctor would do a complete exam as well.
• Next, the assistant took all my x-rays (Beautiful – New Sirona, Digital Panoramic Machine) and she completed the intra-oral photos of every sextant throughout my mouth. She even took a photo of me saying that “now no one else could pretend to be me.” lol
• The dentist now completed the comprehensive perio exam, then the assistant came in and they documented all my restorations.
  • Next the dentist did an extremely thorough exam while wearing his 2.5 loupes and light. (Yes, that is important to me that my clinicians wear at least loupes!)
  • The dentist btw: never did find a fracture. That will be my best Christmas present!
  • The dentist left the room to go talk to the hygienist who would now come “clean” my teeth.
    • Yes, he told me my gums were very healthy and that I had very little cleaning for the hygienist to do.
• Last but not least, the dentist came back with the hygienist and introduced her. The hygienist also wore loupes. That made me very happy! Of course I checked her instruments and they were very new looking Gracey curettes and the latest ultrasonic equipment as well. The hygienists’ scrubs matched the other back-office assistant’s scrubs as well.

Conclusion

2 hours later, I finally left the office. I am happy to say that the only service they inquired about me paying for, other than my $39 appointment I scheduled for, was a fluoride varnish. That would have been $30 US Dollars.

The hygienists’ face to seem a little strange when I declined the fluoride varnish, probably for good reason since I was so concerned about having healthy teeth. Well, you know I have varnish at home so thinking to myself; why would I pay $30 when I have it at home? You get it!

This is the only negative I can talk about:

• The front office lady sked if “I wanted to schedule my next hygiene appointment?” and I always suggest to our clients…
  • Never “Ask” but tell the patient why they need to come back even if it is 6 months from now
  • Tell them a next appointment day and time. (Mention and time and day similar to the same time and day they are currently in your office)
  • Provide a benefit to return to your office (Example: We will check the margins of those onlays to be sure you do not have any cavities around those in the future)
• And #2 is the lady at the front office, when I asked the cost of my next hygiene appointment, she told me “only $75.”

When I inquired more about “only $75” I was now informed that when I return and pay for a “special in-office dental plan” of $111.00 — this is why the next hygiene appointment would only be $75 and the doctor’s exam fee would be “waived.”

She also went on to explain how I would save money in the future if I purchased the $111 “dental plan” and then every 6 months I would only pay $75 for my cleanings.

So let’s get this clear: I will pay $111 for the “Plan” and then 2 times in the next year I will pay “$75?”

That is $111 + $150 and that equals $261.

She said that every 6 months without the plan it would $104 to clean my teeth and the dentist would need to do an exam and the exam every 6 months would be $95! Now we’re talking $398 annually.

She swore I would be saving myself a lot of money if I got the plan!!

I told her I would need to think about this because it does not make sense to have an exam every 6 months since I have never had a cavity since I was a teenager.

The front office lady really did not know how to respond other than that is how they do it.

Not wanting to make any waves after just paying my $39.00, I left with my next 6 month appointment which I will later call to cancel.

Well, I am now going to go to YELP to review the dental office.  I will give them 4 Stars!

Until the check-out part with the lady telling me about paying $75.00 for my next hygiene appointment and nothing more about the “dental plan” and cost of that, (until I actually asked about the $75 cost next visit) I was very impressed and would have given them a 5 star rating. Because of this, I only gave a 4 star rating on YELP.

BTW: One thing the hygienist did tell me is that she was being flown to their corporate office more very EXTENSIVE Training! Can you imagine the cost to fly here there and for 3 days plus a hotel and all the food she would eat. She told me she was very excited to attend this corporate training.

I can honestly say that the experience was one of my best ones!

I am sad to say that never have I ever had such an experience with the dentist speaking with me in private, and never have I experienced such a thorough examination process!

The moral of this story is that if you are in solo practice or if you are wanting to have a few of your own dental offices, you need to understand how the BIG BOX CORPORATE DENTAL OFFICES are treating their patients.

If you question corporate dentistry, maybe you should go undercover and experienced this first-hand. I hope you have the same good experience that I just had.

My question to you: “IF you will be kind enough to comment; should I ever tell them I was “Undercover” and as a dental professional, I think they did a great job!”   ???

What would you do?

Did anything here resonate with you?

What do you need to change in your current practice to get to the stellar level and have all your patients leave your office feeling as if they were treated like the Queen of England or President of the United States?

ABOUT 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!

Be sure you check out our Hygiene Empowerment Program . Register here

Are you concerned about telling your patients they have disease?

If you are concerned, I want you to know that you are not alone!

This is a very common concern that we hear about every month from doctors and hygienists.

It’s so common that many clients, when we begin working with the hygiene team, they feel overwhelmed and so concerned that they will lose their long time patients if they tell them that they have periodontal disease. These are hygienists who really care about their patients. I mean, they consider these people to be a friend!

Do you have the “What will my patients think if I…” syndrome?

Here is what our team of coaches tells our clients:

You are obligated to tell your patients when they have active disease. You can do this in a way that creates an even deeper relationship with patients whom you care so much about.

Today, I share with you the results of an amazing team that had this very concern and they learned how to overcome this situation which can be so challenging.

Be sure to keep reading below because today I will give you some specific words you can use when you experience this challenge and feel concerned.

“How can I tell my long-time prophy patient today, that they have periodontal disease?”

This is a question the team at Nicosia Dental asked before we really got down to business.

The team has worked really hard to build a a great reputation in their community and close relationships with most of their patients.

The#1 goal for this team when they began working with us was to:

• have a system for the hygiene department that is turn-key with a step-by-step implementation process,
• how to make the perio diagnosis (especially when their patients are routine prophys but now have active disease),
• how to make time for all the services a hygienist needs to complete in their allotted time,
• enroll patients into high-end treatment plans,
• update their verbal skills so that now, they will be recommending what is best for their patients while maintaining a trusting relationship

And… the results are in!

Here is the evidence which shows how well they have take action and implemented what they have learned from Hygiene Empowerment:

Here is what they have created in just six months!

Perio Percentage Increased                                425%

Open Hygiene Appts Decreased                          80%

Hygiene Production Increased                              55%

Case Acceptance from Hygiene Increased          40%

Here are the tips you can use to enroll prophy patients into perio:

1. Explain to patients before a bib is placed and the chair reclined.  “Do you have any areas of concern? Any bleeding gums?” Now tell patients: “Mr. Patient, today we will do X, Y and Z (An example of this: “checking for any abnormalities”) so that you don’t have any inflammation, infection, tooth loss or loss of life. I will use this ruler (Show your perio probe) and take some measurements. You will hear me call out some numbers; 1-3 is healthy. A 4 means inflammation and anything 5 or higher means infection. Now, not to be concerned if you hear a 5 or higher because when I am finished with the numbers I will sit you up and we will create a plan to get you back to health. Now, Mr. Patient, I will be asking you at the end to tell me what the lowest and the highest number I call out is.”

• Can you imagine how this conversation will bring your patient into a partnership vs. you, telling patients “What you found”?

2. Look together at what you “see.” Show your patient their previous past perio charts, take pictures of bleeding gums, calculus, etc., with the intraoral camera or have them hold up a mirror and look with you.

3. Use words you know your patient understands. Do you know for sure that your patient understands what the word “Periodontal” means? Try using words and phrases such as: gum or bone infection, inflammation. Don’t be afraid to say “bleeding and bleeding gums.” Nix that word “Cleaning” and never use the phrase “Deep cleaning.” Tell your patients they will need some gum treatments and if they do understand the word periodontal, explain this is non-surgical periodontal treatment.

4. Explain that gum (or periodontal) disease can cause other systemic diesases.  If your patient does have high blood pressure or diabetes, etc., explain how this can exacerbate their current inflammatory disease(s) and explain that treatment of their gum infection can help improve their systemic disease. Talk about gum therapy or gum treatments as a way to prevent other diseases such as heart disease, Alzheimers, various cancers, etc., etc.

5. Tell patients: “I care about your total health!” What impact will this sentence have on your  patients (some who already consider you a friend)?

How smoothly is your treatment planning process going today?

– – Are hygienists helping to enroll 70%+ of all treatment plans?

How is your case acceptance from hygiene appointments?

Do all the hygiene clinicians agree when a patient is healthy or has disease?

– – Does one hygienist say the patient is healthy and there are no probing depths above 4 mms while other clinicians (Maybe doctor) say the patient has 5 and 6 mm probing depths?

– – What do you do in this situation? Do you know the cost of hiring a new hygienist vs. asking for help from an expert to work with your existing hygiene team?  Typically, it is much more expensive to go out and hire a new hygienist!

Are you satisfied with your answers above?

Check out our Hygiene Empowerment Program and then enroll in our no-cost 3-Part Hygiene Empowerment Video Series, EBOOK about treating gingival diseases and get access to our most recent webinar “5 Steps to Creating a More Productive and Profitable Hygiene Department.” Register here and get started today!

This subject of this webinar was Hygiene Department Empowerment.

There were hundreds of dental professionals in attendance.

We were at maximum capacity and if you want to be included in this information to boost your hygiene department you can enroll in the webinar to receive the recording and also the 3-Part Hygiene Empowerment Video Series plus an Ebook about treating the gingivitis patient, according to the American Academy of Periodontology.

During the webinar we had numerous questions and I will re-cap 3 of them here:

1. “What happens after we do scale and root plan 1-3 teeth?”

Answer: After scaling and root planing you will want to bring your patient back 4-6 weeks for a “tissue check,” aka: “re-evaluation” or “post-op” visit.

After a long conversation with Dr. Charles Blair, he says that most insurance companies will not pay for the visit 4-6 weeks. The American Academy of Periodontolgy explains about checking the patients “balance-point.” unless you see the patient 4-6 weeks after scaling and root planing, you will never know if the active disease has been put into remission. It is very important to know if the perio therapy has resolved the active disease before you schedule them for three or four month periodontal maintenance appointments.

Dr. Blair told me that you can bill insurance for a prophy after you complete 1-3 teeth of scaling and root planing however, there are insurance companies that will never pay for periodontal therapy after you have billed for a prophylaxis when periodontal therapy was completed and billed to the insurance company.

The most important thing to remember is that you need to document and bill insurance, what services you actually completed that day.

Dr. Blair told me that as clinicians we need to tell our patients that they will need to pay because their insurance may not pay for the service.

2. “What should a hygienists’ production be per hour?”

The most important thing is for dentists and hygienists to “know the numbers.”

It is not uncommon that we see hygienists who have production of approximately $800 USD per day however, after we begin working with a hygiene department and they implement a higher level of patient care: scaling and root planing followed by perio maintenance visits and sealants, fluoride, etc., it is not uncommon to have hygienists average $250 per hour USD.

3. “If you register for Hygiene Empowerment” when does it begin?

Answer: Once you enroll, for example if you send in your registration by or before Friday November 13, 2015, you will begin on Monday November 16, 2016. On Monday you will receive your first video module which is approximately sixty minutes long as well as the video transcipt and your implementation guide. My office will call your office if you are open on Monday and we will schedule your calls/webinars with the hygienist(s) and with Debbie and doctor(s).

All of our current clients enrolled in the program triped their return on the money invested within three weeks of the hygiene program. The program works because we monitor specific hygiene department metrics weekly and monthly a full office report is reviewed with doctor to create a plan of action for the next 30 days and eliminate any inefficiencies that made me discovered.

• Do you want to have a collaborative hygiene department?
• Do you wish doctor and hygienist or all the hygienist could agree when it’s a prophy patient and when it is a periodontal patient?
• Do you want a more empowered team?
• Do you want to not work as hard?
• Do you want to understand how to enroll patients who were always a prophy into periodontal therapy?
  • Are you comfortable changing routine patients from prophy to perio?

The above questions are addressed in Hygiene Empowerment. Do not begin 2016 without looking into your future “Hygiene Empowerment.”

It works! Hygienists are getting really excited about this! Just ask to see all the emails they have sent because they are so excited about this.

ABOUT 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

o   This means doctor can come to the office to do their job as Dentist not manage people