Clackamas Dental Consultant | Dental Practice Solutions | Dental Consultant Near Me

Without A Strong Foundation The House Will Fall

By: admin

March 5, 2019

The young associate dentist evaluates a new patient.

This patient is a 50-year-old woman, who is a type II diabetic, and taking medications for both diabetes and high blood pressure. She is missing her lower right first molar (#30) and has several old amalgam fillings that are breaking down plus, they all have recurrent decay.

The woman has periodontal probing’s measuring 4-6 mm’s in depths. The periodontal infection is localized to the posterior quadrants and includes a 6 mm distal pocket depth on #31. All of the periodontal pockets have BOP.

Excited, the young doctor immediately discusses and schedules a three-unit bridge to replace the missing #30, with abutments on #29 and #31.

WHAT IS WRONG WITH THIS PICTURE?

To use the analogy of building a house, this young doctor placed the roof before he poured the foundation. I can still remember from many years ago, when I was in dental school, they gave us a sequence that we were told to never violate. Oral surgery, endo, perio, restorative, and finally; prosthetics.

When we presented our dental treatment plans to our instructors, we always had to follow this same sequence.

FOUNDATION- FLOOR- WALLS -ROOF

The Foundation refers to removal of infection and any non-restorable teeth. If there are teeth that cannot be saved, get them out of the mouth first! Stop pain and take care of any abscesses. Either treat teeth with endodontics or extract them. This is important to eliminate systemic infection because we know that infection in the mouth causes infection in the does body.

There is one exception to this rule: you must address the patient’s primary need first, IF, it does not seriously violate the rest of the sequence. An example could be, a missing filling in a front tooth, and the patient was self-conscious about the esthetic problem.

The Floor can be built. The floor is built on the foundation and is similar in function. Our next step is to control or eliminate any periodontal infection so the patient will have a strong foundation that will not become progressively worse after we build our fine restorations.

This is the rule that the young dentist in the above story broke. He constructed a bridge before he had cured the periodontal problems his patient had. I can’t imagine trying to locate where the margin on the abutments will be with the pocketing present, the over extension into a sick periodontal pocket, and trying to have a dry field when trying to cement the bridge. This treatment can include debridement, scaling and root planning, any grafts and surgery that may be needed, and maintenance to be sure our house will be strong and healthy.

The Walls can now be placed on a healthy, strong foundation and the floor. The Walls can be compared to doing the necessary removal of decay and broken fillings present in the patients mouth. This will make smoother margins and will often uncover decay that may be present. Now we must go back to our foundation. If there is a pulp exposure this requires treating the nerve before going any further. When a tooth needs a crown later in the process, sometimes a core filling will be needed to make sure the tooth is strong and will retain the crown.

The Roof comes next. This can include a number of procedures, including the bridge our young doctor immediately decided was the most important project; the shiny thing, the high priced project he wanted to get completed in the first sequence of the treatment plan. Unfortunately, this sequence of treatment is the case too often. We hear of all the total restorative make-overs, the implant retained prosthesis that are done in one day, and also the twelve veneer cases that are done on the second visit in some offices. My prayer is that when you place the roof on your cases, you have made sure the foundation, the floor and the walls are all solid, so that the roof won’t collapse, a few years after you have placed that last nail to hold the shingles in place.

FOUNDATION, FLOOR, WALLS, ROOF. Make sure you follow the correct treatment sequence and work through each needed step to insure your patient’s dental house will be strong and last for many years to come.

About Dr. David Black, DDS, FICD, FACD

Dr. Black is currently an associate coach and consultant, for Dental Practice Solutions, one of the leading consulting firms for nearly twenty years. As a seasoned practitioner, Dr. Black adds to the proven hygiene profitability coaching that Dental Practice Solutions is well-known for providing, to dental practices around the world.

Dr. Black’s expertise as an EQ and DISC trainer, makes him the best person to help more patients to say “YES!” to your patient care, as well as to enjoy working together as a team and loving what you do for your patients!

To schedule a No-Cost Profit Boosting Session Contact Dr. Black Here

How to Grow an In-House Membership Program

By: admin

January 9, 2019

Debbie Seidel-Bittke, RDH, BS, talked to Jordon Comstock, founder and CEO of Boomcloud about their membership program.

Dental Practice Solutions niche is teaching hygienists how to talk to patients about necessary treatment and Boomcloud is a great adjunct to helping patients pay for the dental treatment they need.

dental-practice-solution-inhouse-membership-program

During this short podcast, Debbie and Jordon talk about:

1. A predictable, recurring revenue stream for your dental practice.

2. They talk about a specific tool to help market your dental practice.

Attrition is a part of every business so this is one important tool you must learn about to help market your dental practice and create sustainable profits.

3. They also talk about reducing a dentist’ dependence on PPO’s.

4. When you listen to the podcast you will learn the benefits of a “subscription system.”

a. Think Amazon Prime but for your dental practice.

We are in a new age of dentistry and this information will bring you into a forward-thinking world to grow your dental practice.

How can we help you grow your dental practice in 2019?

Please call us @ 949-351-8741 or Email Us to schedule a No-cost profit boosting session Click to Schedule and discover the easiest way to make 2019 your best year ever!

ABOUT THE AUTHOR

Debbie Seidel-Bittke, RDH, BS, is one of Dentistry Today’s top dental consultants. She is an international coach, speaker and author. Debbie is the CEO of Dental Practice Solutions.

Debbie is a world-class leader in creating profitable dental hygiene departments. She is a well-known as a former clinical assistant professor at USC in Los Angeles and a former hygiene department program director.

Dentistry Today recognizes Debbie as a Leader in Dental Consulting for the past 16 years.

Steps to Crack the Cancellation Code

By: admin

December 11, 2018

The holidays are here, and your patients have a lot of tasks, parties and Christmas shopping to do before December 25^th.

The last thing they have on their mind is a dental appointment.

Cancellations are at all time high; call it a pandemic!

In a normal day at your office, how many patients call to change their dental appointment?
How many patients are calling on the day of their dental appointment to let you know they can’t be there?
How many of your patients flat out, don’t show for their dental appointment?

The holes in your schedule are costing you thousands of dollars each week and these dollars add up to hundreds-of-thousands-of-dollars annually. The lost revenue equals millions of dollars. during the lifetime of your dental practice.

Solutions

When you register for this 5-Day Free training you will view short videos of information you can implement right away.

Some of the important parts of reducing cancellations are:

Letting your dental patients know what you expect
Have a cancellation procedure in place
Procedure for voicemail messages
A system around value and benefits to your dental patients
What to say when patients DO call to “change their dental appointment

There is a wealth of information you can implement immediately when you do register for this free training.

You can’t lose. You only eliminate the holes in your dental schedule and lost revenue when you enroll now in the free training and implement what you learn over the next week.

Register for the Free 5-Day Training Here.

ABOUT DEBBIE SEIDEL-BITTKE, RDH, BS

CEO: Dental Practice Solutions

Debbie Seidel-Bittke is not only the CEO and founder of Dental Practice Solutions but she has been known for the past fifteen years as one of Dentistry Today’s Top Dental Consultants. She is the only consultant with expertise in growing the dental practice by implementing systems and processes to grow a dental hygiene department by Dentistry Today.

She has a background in academia as well as a former dental hygiene program director.

You will read many of her articles published in dental journals and she has spoken at most of the national dental conferences. She works with dental practices on a global level. Read more about her here.

Creating a Culture of Payment

By: admin

December 4, 2018

I recently had a chance to sit down with the A/R Ninja, Andy Grover Cleveland.

During this short conversation we not only talked about how to create a culture of payment, but we talk about how important it is to bill your patients and call them regularly when they owe you money.

Andy will share why it is important to use a 3rd party to bill and he will let you know when it is best to get a 3rd party involved in collecting money in your dental practice.

Stick to the basic principles:

Outsourcing your dental insurance.

In today’s world dental professionals have a lot more responsibility and therefore outsourcing your dental insurance is very helpful for efficiency.

Empower your team to use their judgement when doing their job.

“Mr. Patient, it will be $599 today, how would you like to take care of that today?” Now the PAY-tient says, “My brother-in-law plays golf with doctor, so I will talk to the doctor about this.”
You must have parameters and stick with the plan.
Payment options must be clear.
Know what the rules are and empower your team to live by the rules.
Doctor, you can’t change the rules and make exceptions.

Pay-tients must pay at the time of service.

Billing and Calling Pay-tients regularly

Communicate routinely when your Pay-tients owe you money.

You can do collections but maybe.
Checkout the Tennessee Backwoods Dentist on youtube to see, are you equipped to do some of these important tasks yourself?

Where do you spend your time daily in the dental office?

There are too many things “to-do” in a given day in the dental office and outsourcing collections, etc., can be very efficient for running a dental practice.

Question: What is the average for accounts receivable (A/R)?

Answer: Debbie and Dental Practice Solutions recommends 98% collections.

Andy mentions that for a start-up, you don’t want a high overhead.

If you have a mature practice, now you can do in-office financing and you may not need to have the high monthly collections.

If your personal finances can weather a higher A/R to allow more patients to make payments (in-house) on high-end services, then a higher A/R may work for your dental practice.

Andy states: “Every time you send a statement to a Pay-tient you are sending a message that you have made a mistake.”

What is the best way to contact a patient who owes you money?

Andy says that it depends upon the individual person. Keep the end in mind and try not to send statements. Try using all the avenues for sending statements; email, paper statement mailed and/or a text message with a link to pay.

Andy also says,
Dentistry is non-recourse.

Recap of the Podcast:

All patients are asked to pay at the time of service.
If patients do not pay at time of service, they will leave with a statement
Work A/R weekly.
Call outstanding A/R Pay-tients to ask, “how is (state the last service, area in their mouth treated), feeling?
If it doesn’t get done, it won’t get done without someone doing it. Hire a service that will get it done.
Focus on your “core competency…for doctor that is clinical dentistry.”

Debbie says:

Understand, has your engine light come on? Is it blinking? If you said Yes, you need to outsource this area.

Be sure you don’t miss another info-packed FB live. Come over to our Facebook Business page for daily tips, inspiration and our weekly Facebook Lives:

Do you wish you had more Pay-tients say “YES” to your care?

Check-out our Case Acceptance/Treatment Planing Mastermind.

The next session begins the week of January 7, 2019.

How do I know if this mastermind is right for my dental practice?

The Mastermind is great for dental practices who:

Want more hygiene patients to accept high-end services

-More implants, more crown/bridge, Invisalign, etc.

If your case acceptance is less than 90%

If you have one hole in your schedule each day

If you want your production to be higher

If you want more patients to pay at the time, they schedule for your care

Contact our office for the application.

Registration is limited to ONLY 10 offices.

When you contact our office, we will provide the mastermind details.

The 30-Day Mastermind is $795 and has a MONEY BACK GUARANTEE!

Email us: admin@dentalpracticesolutions.com

Or Call for application: 949-351-8741.

Systems Patients Can Expect During Their Dental Hygiene Appointment

By: admin

October 24, 2018

Why did you purchase the car you are driving?

Why do you shop at the grocery store you frequent and why do you stay at a specific hotel when on vacation?

The answer to these questions should be the reason why your patients come to their hygiene appointment routinely.

What can your patients expect during their routine hygiene appointment?

There are a few systems patients can expect during their dental hygiene appointment when you have systems I place.

This is about consistency. It’s about efficiency and making people feel like they are Number 1!

Does each hygienist in your dental practice know what services they will complete on each patient, at specific hygiene appointments?

Each one of your team members should also know about these systems.

There are many services that hygienists provide patients during a hygiene appointment.

Having written systems for hygiene appointments will make life easier for employees, your team members as well as, keep your patients returning because they feel valued. Your systems provide the best care for patients and your patients feel it.

It is very important for hygienists audit the patient record before they begin their day. This morning or day before seeing patients, is the first system and a good place to begin when implementing systems. The patient- record – audit – information, is used during your morning team huddle.

Here is a list of the services your patients should expect to receive during routine dental hygiene appointments. Your system will include all of these and maybe more:

Build rapport

This is probably the most important part of your appointment. Take note how many of your patients are seated without a bib being placed on them right away?

Just sit and catch-up or if this is the first time you are meeting, take time to ask about them. Find out something unique, interesting and something fun to remember.

You will be amazed how great it makes your patient feel to just sit a few minutes and chat rather than sit with a bib on their chest immediately.

Update medical history

This is where you need to be the detective. Ask more than “Any changes in your health?” It is very important to ask questions like, “What medications do you take?” Medications can affect their oral health, cause xerostomia, etc. Ask, “Do you take herbs?” Some herbs can cause excessive bleeding.

Ask, “Any surgeries?” Be sure to ask, “Do you take blood thinners, do you have any teeth that concern you?”

The next step is to inform your patient about what services you will provide for them. Consider this as “consent to treat your patient,” even if you believe they know why they are there.

Once you have informed your patient and they have informed you about their health and any chief complaints, you must know what interval your dental practice will take BWXs, FMXs and PA’s.

Does your office use the latest ¹fluorescence technology? Our hygiene team recommends that dental hygienists complete this type of screening once a year. HPV is on the rise causing oral and pharyngeal cancers.

We are in the business of saving lives!

Once you have competed these screenings it is time to check the health of your patients’ gums.

How often does your dental practice recommend a comprehensive periodontal exam (CPE)? See the recommendations from the ²AAP to know if you are providing the standard of care.

If your patient is not due for an annual CPE, what is your protocol to spot probe to be sure your patient does not have any new areas of inflammation or infection?

Which teeth do you spot check? And why these specific teeth do you spot check?

More systems:

Treatment planning /Coordinating the treatment plan with your patient.
Doctor/Hygiene Exam. When does doctor know to arrive in the hygiene room to complete the hygiene patient exam?
Scheduling the next appointment. When patients need to return for a routine hygiene appointment, we recommend the hygienist schedule this appointment when the patient is finished with their hygiene appointment and before they are escorted to the front desk.

The hygienist has spent in most offices we work with, fifty minutes looking in the patient’s mouth, and they are the best person to know exactly when the patient needs to return and why it is important for them to return at this specific time.

What written systems does your hygiene department have?

Conclusion

When systems are in place, people will know what is expected. When everyone on your team knows what is expected your dental practice will run efficiently. Your systems need to have information that will allow your team to have the information they need to provide the best patient care.

When you provide the best patient care, you will have patients who feel well-cared for and these are the patients who continue to return to your office indefinitely.

References from the blog:

Does your hygiene department have a system in place to support each of the identified services in a routine hygiene appointment? If you don’t have all systems in place or you want to “Up Your Game,” let’s schedule a time to chat! Call our office to schedule a time: 949-351-8741. You can email to schedule: admin@dentalpracticesolutions.com or Schedule directly from our calendar here.

About the Author

Debbie Seidel-Bittke, RDH, BS, CEO Dental Practice Solutions

Debbie Seidel-Bittke, RDH, BS is founder and CEO of Dental Practice Solutions. She is also a former dental hygiene program director. Her expertise is optimizing the hygiene department by taking a total team approach; including the doctor as the leader.

Schedule your no-cost Profit Boosting Session Here Today. You can also call our office to schedule: 949-35-8741 or email us.

Dental Hygienists, What Does Your Cheat Sheet Have on It?

By: admin

October 16, 2018

Dental Hygienists have so many tasks to complete every day at the office and with every patient they see. My question is this, Dental Hygienists, what does your cheat sheet have on it?

As our team of consultants works with dental teams and dental hygienists around the world what we notice is that important tasks, valuable parts of a dental hygiene appointment go “untouched.”

Here are some examples:

• Patient rapport

Patients are greeted but immediately seated in the dental chair. A patient bib goes on and back they recline in the dental chair.

How do you connect or reconnect with your patient in your chair?
What do you know makes your patient feel like they are more than a tooth and more than a way for doctor to pay for their next vacation?

A quick reconnect or connection with your patient means a lot and it takes about 2 minutes, maximum.

Ideas for quick rapport building are:

Patients of record
• How is your son doing at University of ABC?
• Did you see that new movie 123ABC?
• Are you planning any new vacations?

New Patients
• I see you are new to ABC City, what brings you to ABC City?
• Looks like you work for Amazon, what do you enjoy most about working there?

When speaking to a new patient use ice-breaker type of questions as listed above. Make the conversations light-hearted and easy-to-answer.

The Most Valuable Cheat Sheet

After you have seated and greeted your patients, you have a lot of task and services to complete so what type of cheat sheets do you have available in your treatment room to remember everything you need to do during your dental hygiene appointment?

We have created laminated cheat sheets for the dental hygiene teams we work with.

Please contact our office for your own cheat sheet and you can laminate to use during your day with patients.

One cheat sheet we have found hygienists like is the Comprehensive Periodontal Exam. Many hygienists we meet do not know all eight areas to annually evaluate to determine if your patient has a healthy mouth, active disease or gingivitis.

The areas listed on the Comprehensive Periodontal Exam Cheat Sheet are:

1. Six-point pocket depths
2. Recession
3. Mobility
4. Furcation
5. BOP (Bleeding upon probing)
6. Mucogingival Involvement
7. Suppuration/Pus
8. Occlusal Issues

Another Valuable Cheat Sheet Lists “Areas a Dental Hygienist Needs to Report on During the Doctor/Hygiene Exam.”

We teach a specific system for all team members to transition (Dismiss) a patient from back office to the front office. This is a five-step program.

Let us know if you use a “Cheat Sheet” and if you believe this can be helpful to your team, please email us to share some of our cheat sheets with you and your team.

Need help implementing these areas in your dental practice? Do you have a system to support each of these areas listed above?

We can help! Contact us today to find out how we can help create these systems and find out how to Implement the systems that create success without working so hard.

About the Author

Dental Practice Solutions is able to support your dental practice with supporting your front office admin skills, insurance billing, reimbursement as well as credentialing and increasing your PPO fees.
Schedule your no-cost Profit Boosting Session Here Today. You can also call our office to schedule: 949-35-8741 or email.

Dental Professionals: Are You Wearing the Correct Size Gloves?

By: admin

October 9, 2018

Doctors, Hygienists and Assistants, are you wearing the correct size gloves?

I imagine you are very comfortable in the size glove you wear currently but if you are experiencing carpel tunnel, trigger thumb or even neck pain, keep reading and view this video to see how you know if your glove is the correct size.

When I tell a clinician, they are wearing the wrong size glove they always tell me that the bigger size glove is too big for their fingers.

To hold an instrument or hand piece the most important part of your glove is not the finger fit, it is the palm of your hand.

A glove that allows the palm of your hand to move around freely is one that will never cause the above physical problems mentioned above. A correctly fitting glove will allow you to access a deep pocket, it allows you to angle your probe correctly and for the doctor, this becomes very important when you are prepping a crown and may make it much easier to extract a tooth.

When you wear a glove that fits correctly you will notice less tears, which means it is a lot safer for you, the clinician.

According to Donna Gaidamak, media relations manager for Cardinal Health, wearing a glove that is too small with cause hand fatigue, skin irritation and damage.

After reading this blog and viewing the video, I challenge you to return to your office and check to see, are you wearing the correct size glove?

are-you-using-the-right-size-gloves

Please be sure to “Subscribe to our blogs and YouTube channel.

ABOUT THE AUTHOR

Debbie Seidel-Bittke, RDH, BS

Debbie is known as one of the top leaders in dental consulting. She speaks, and consults with clients all over the world. She is a well-known author, published in most of the dental journals for over 18 years.
Debbie has a unique way of engaging with doctor and the team, so they have patients who accept treatment, schedule and pay as well as, continue returning to your office indefinitely.

Do you or your team member(s) struggle with the “all saying the same thing to patients?” Do all your hygienists treatment plan and sequence perio and gingivitis the same way?” Not sure how to sequence treatment for gingivitis? We are here to help! Just give our office a call or email to schedule a call so we can explain how we will help you with this bump in the road. We will also provide AGD CE Credits with your training (in-office or web-based). Just ask us how it’s done: email or Call our office: 949-351-8741. You can also schedule your session to find out more about this here.

What Do We Say When a Routine Hygiene Patient Has Periodontal Disease Today? (Part Two)

By: admin

October 5, 2018

Part II

In Part I, we discussed what to say to this patient.

In Part II I will talk about what our American Academy of Periodontology and the research says about this. You will read about other publications and what the general public has access to regarding treatment of gingivitis and periodontal disease.

The intent of reading this information is to answer this question, “What Do We Say When a Routine Hygiene Patient Has Periodontal Disease Today?”

What Others Say:

The American Academy of Periodontology (AAP)addresses this situation on their website. As dental professionals we know to look at the AAP as the “gold standard” for treating and preventing periodontal disease.

You will see many of the messages about oral health and it’s role in total health in men and women’s magazines.

The National Institute of Health Library, has extensive research on the mouth body connection and how oral disease contributes to various systemic diseases and cancer.

Your Message

Many dental clinicians today still find it awkward to talk with routine prophy patients about a change in their oral health.

What we have discovered working with many dental offices around the world is that when clinicians have routine prophy patients return with bleeding gums and in many cases, undiagnosed periodontal disease (an ex-employee/clinician missed this diagnosis), the clinician feels uncomfortable delivering the message to their patient about gingivitis and/or periodontal disease.

Patient care in the dental office must be about the patients’ well-being, their total health. Patients are paying for your expertise and you must be open to sharing the true picture of their oral health and how it relates to their total health.

Not Only About the Tooth.

Before you begin assessing your patient, at the beginning of your hygiene appointment, it will be helpful if you tell your patient what you will be looking for. Begin by confirming the services you have planned to complete at the beginning of your appointment.

Before you pick up a probe to assess the health of the patients gums, explain about the “ruler” used to measure the space between their gum and tooth. Let your patient know what the numbers on this ruler mean.

It becomes very valuable to have another team member to chart your numbers in the perio chart or technology such as the “Florida probe” to call out the numbers and record. The hygienist or doctor will call out the numbers during a comprehensive periodontal exam and another person will chart the readings. If you have the Florida Probe (or another software to record the readings) you won’t need something to write the numbers.

In Part I, we shared how to inform your patient about the numbers. Examples of this will be, “ if you hear a 3 or less, your gums are healthy, a 4 means inflammation, 5 or higher means you have infection in your gums. If you hear a number 4 or higher, when I am finished with the exam, we will create a plan to get your gums healthy again.”

Ask your patient to listen for the numbers and at the end of the comprehensive perio exam ask them to tell you the highest and the lowest number they heard you call out.

After your patient hears the numbers, this is where you can begin the partnership and collaboration with your patient.

Engaging your patient in the exam process makes it easier for them to be a part of a treatment plan when you need to talk about something outside of healthy teeth and gums.

Use words that your patient will understand during each appointment and especially when you discover something abnormal such as gum disease.

When you say words like “Periodontal Disease,” you are more likely to see a glazed-over look in their eyes. People will tell you they understand but if you say words like “gum disease” your patients will be a lot more likely to understand what you are talking about.

Next Steps After You Assess

Once you are looking in your patients’ mouth, take pictures of what you see.

Once you have collected all of your information during your assessments, including your intra-oral pictures., sit the patient up-right in the chair to talk with them, knee-to-knee and eye-to-eye.

Now is the time to create a partnership with your patient and help them make the best decision to create a healthy body.

Once a patient has inflammation and infection in their mouth our role is to help the patient understand how this affects their overall health.

Showing your patient pictures about what is happening in their mouth paints a picture and is more descriptive than words can express.

Words You Want to Use:

-Preventive Care vs. Cleaning

-Hygiene Appointment vs. Cleaning

-Gum Treatment vs. Deep Cleaning

-Gum Therapy vs. Periodontal Therapy

-Gum Maintenance vs. Periodontal Maintenance

-Active Disease vs. Periodontal Disease

-Inflammation vs. Periodontal Disease

-Infection vs. Periodontal Disease

-Routine Care vs. Periodontal Maintenance or Cleaning

-Abnormalities vs. Cancer

-Ruler vs. Probe

Treatment Planning Phase

After your patient has heard the number’s you called out during the “assessment of their gums” when you do find abnormalities, inflammation, infection, active disease, etc., you need to seat your patient upright in the chair and show them what you see.

Since you have already explained what the numbers they will hear during the exam mean, they already understand if they have inflammation or infection and you won’t find yourself in a position of objections from your patient. They understood what to listen for and what the numbers mean, so a lot of your hard work explaining has been completed. You have also told your patient at the beginning that if they hear certain numbers you will create a plan for health.

This first conversation before you begin your assessment, ends up saving you time and a lot of effort explaining. Most patients , when they hear the 4, 5’s and higher, will tell you, “That did not sound too good!”

This type of communication makes it much easier to collaborate and create a treatment plan. It will get patients to want what they need, schedule and pay for treatment.

Our Responsibility

We have a legal and ethical responsibility to let our patients know when they need something different than what they are scheduled for.

If your patient is scheduled for a crown prep and the doctor discovers more decay than originally seen on radiographs or from a visual exam, that doctor will typically stop the planned treatment (Stop the drilling when they see the decay has gone too far into the nerve) and discuss with the patient what they see and how much more decay is in the area. The doctor will let the patient know the treatment plan is more extensive than originally planned.

When a patient comes to their prophy appointment and you discover this is going to be more than a prophy you must do the same thing. You will show the patient what you see and bring them into a partnership to own the disease in their mouth.

Our team runs into many objections from hygienists and dentists who are concerned about “what the patient will think if they are told something different (than planned) needs to be completed. Too many dental professionals are concerned about the patients having a negative response to knowing it is “more than a prophy appointment.”

We must tell our patients what is truly happening in their mouth and their body. The dental appointment must be patient centered and not about what “WE” the clinician thinks our patient can pay for or if they will be upset that we have discovered an abnormality and they need a different treatment plan.

How do you know if you are doing the proper treatment planning with your hygiene patients?

The American Academy of Periodontology estimtes (Back in 2012 was the last documentation) that 62 million American adults have periodontal disease. A typical percentage of adults we see being treated for periodontal disease is about 40% of their adult population over 30 years of age.

We have also noticed that if a hygienist sees eight patients a day they will have about one gingivitis patient each day.

What are your percentages of patients being treated for gingivitis and periodontitis?

We are happy to take a look and use our data collection formula to help you correctly assess and diagnose.

Is your office receiving payment for treating gingivitis patients? Please let us know how we can help you receive payment for treating gingivitis and periodontal patients. We enjoy helping offices like yours, understand how to correctly treatment plan, sequence treatment and then get patients to schedule, pay and return for preventative care.

We can help! Just give us a call or email us and we will share more with you.

About the Author: Debbie Seidel-Bittke, RDH, BS, is one of Dentistry Today’s top dental consultants. She is an international coach, speaker and author. Debbie is the CEO of Dental Practice Solutions.

Debbie is a world-class leader in creating profitable hygiene departments. She is a well-known as a former clinical assistant professor at USC in Los Angeles and a former hygiene department program director. Dentistry Today recognizes Debbie as a Leader in Dental Consulting.

What Do We Say When a Routine Hygiene Patient Has Periodontal Disease Today?

By: admin

September 25, 2018

Part I:

Most hygienists see approximately eight patients in an eight-hour day.

Not all of those patients will be healthy.

Most hygienists will report daily one patient (Some days more) with gingivitis and at least one patient will be diagnosed with periodontal disease or they are returning for scaling and root planing.

The question and challenge many dental practices face is when a routine hygiene patient returns six months later and now they have gingivitis or worse, periodontitis.

What do we say when a routine patient has periodontal disease?

In Part I, we will discuss what to say to this patient.

What we must tell our patients whenever they have an abnormal condition in their mouth is…the truth.

How we say this is a different story.

This is where clinicians feel challenged.

What will make this challenge much easier is bringing the patient into a partnership to help make the diagnosis.

How you will bring your patient into the partnership:

Step 1: Rapport

The first 90 seconds of your patient appointment must focus ON your patient.

Get to know your patient and if you do know your patient get re-acquainted.

Ask about their weekend or what they are going to be doing this summer, Christmas, etc., etc.

The purpose is to make your patient feel like a valued human not a mouth.

Your appointment is not about making money it is about helping your patient live a longer and healthier life.

“We are in the business of saving lives.”

Step 2: Inform

Before you put a bib on your patient or lay them back in the chair, inform your patient about what services you will complete.

Explain what you will be looking for and what they can expect to see, feel and/or hear you say.

What will you say to your patient?

Here is a short example:

“Mr. Smith, today you are here for your routine preventive care appointment. Doctor has also asked me to take x-rays of your teeth. After I take a few x-rays I will look for any abnormalities. I will check your tongue, cheeks, floor of your mouth (continue explaining about the oral exams you check at hygiene appointments) and I will use this ruler with millimeter markings to check the health of your gums. If you hear me call out 1,2 or 3, this means your gums are healthy. If you hear me call out a 4 or higher that means you have inflammation and infection in your gums. If you hear these higher numbers, we will create a plan to get your gums healthy. I want you to listen to these numbers closely because when I am finished measuring I will ask you, what is the highest and what is the lowest number I called out?”

I have been hearing clinicians say, “I will poke your gums.” True story. And I also hear, “This may hurt a little.

”Of course, it will hurt if you tell them they may feel pain!

The message here is; don’t set your patient up to feel pain.

After you explain what you will be doing during the hygiene appointment, now you put the patient bib on and lay them back in the chair to begin your exam and assessments.

Step 3: Create a partnership with your patient

Once you are finished with your assessments and you have gathered all of your information, sit your patient up in the chair.

Have your periodontal chart, x-rays and digital photos in front of the patient so you can show them what you saw in their mouth during your exam.

With pictures in front of the patient, ask them about the numbers you heard you call out. Remember, you asked your patient to tell you the lowest and highest number you called out?

Usually when patients hear numbers that they know are not good, they will let you know they the numbers did not sound good.

Once your patient is able to tell you what they heard, your job becomes much easier when you need to tell them what you saw in their mouth.

This is where it takes away any negative challenges you may have with telling your patient they have periodontal disease.

Why is it that if we have a mammogram, the doctor will tell the patient if they see an abnormal area on the x-ray?

What does a doctor tell their patient they have a polyp during a colonoscopy?

Does a dentist tell patients when they have a cavity?

I believe you said “Yes,” to all of the above questions so my question now is this, “Why are you uncomfortable telling your patient they have periodontal disease or maybe you don’t want your patient to know they have gingivitis today?”

Let’s reverse these above scenarios.

You have a mammogram and the doctor is concerned you won’t return because they told you about the abnormality on your x-ray.

You had a colonoscopy and the doctor found a polyp, so they left it there concerned you would not be happy if this is present inside your colon.

You see tooth decay and don’t want your patient to be concerned it will cost them a lot of money to fix this or you think their insurance benefits are maxed out and the patient would have to pay for the restoration.

How does this make you feel?

Are you cringing?

I think you are reading this and not in agreement that the doctor would not tell the patients about the abnormalities, the polyps and areas of decay.

It is the same exact thing with periodontal disease and gingivitis.

If we do see this for the first time or maybe it is not the first time, but we must tell our patients what we see.

We must create a partnership with our patients and bring them into the decision-making process.

Who are we as dental professionals to choose if our patients can afford treatment for gum disease?

Who are we to withhold this valuable information?!

Let’s remember, we are in the business to help our patients live a longer and healthier life.

It is not up to us to decide which treatment our patients may not want to schedule and pay for.

Let’s leave the final decision up to our patients.

Our role is to understand how to best deliver this message.

Step 4: What to say when you discover disease?

When you are completing the comprehensive periodontal exam (CPE) if you have told your patient what to listen for and if you ask your patient to tell you the numbers they heard you call out, it takes away a lot of the explaining what is needed.

Most patients will know what is happening in their mouth if you have prepared them.

When you are explaining what you see with your patient, make sure to sit near your patient.

Notice that I write the word, “sit.”

If you patient is lying back in the chair and you are talking to them, know that their brain is jumbled.

If the patient is seated upright in the chair, they are thinking clearly, and you can effectively communicate.

Use words your patient will understand for example, gums not periodontal.

Say words like “infection, inflammation, bleeding, pus, swelling, preventive care, gum therapy, gum treatment, routine maintenance of your gums, etc.

Conclusion

Today’s world of dentistry provides great knowledge about the mouth-body connection.

As we evolve and grow our dental practice understanding what will keep our patients returning to our office is key to our future success.

If you share the truth with your patients showing them what you see, it will most likely come across as “caring.”

Most patients will believe what they see.

Never be afraid to speak the truth.

If you don’t feel comfortable telling your patient what you see, when they do choose another dental office and find out that you did not tell them the truth about their oral disease, how will they feel about you?

Sure, you were not comfortable telling your patient they have infection and disease, etc., but how will you look if another dentist does tell them and your patient of the past ten years learns you never told them the truth about their oral condition?

What will your patient think now?

Return to our blog site next week for Part 2 when I share more of the research, the science and what the American Academy of Periodontology says about gum disease.

Do you or your team member(s) struggle with the “what to say when a routine hygiene patient has gum disease or gingivitis? Not sure how to sequence treatment for gingivitis? We are here to help! Just give our office a call or email to schedule a call so we can explain how we will help you with this bump in the road. We will also provide AGD CE Credits with your training (in-office or web-based). Just ask us how it’s done: email: admin@dentalpracticesolutions.com or Call our office: 949-351-8741. You can also schedule your session to find out more about this here.

About the Author:

Debbie Seidel-Bittke, RDH, BS, is one of Dentistry Today’s top dental consultants. She is an international coach, speaker and author. Debbie is the CEO of Dental Practice Solutions. D

Take your hygiene department to the next level. Enroll in our course.

Objections to Scheduling Dental Treatment: How Do You Overcome Objections and Get Those Patients Back in Your Chair Today!

By: admin

September 20, 2018

Oh, the excuses we hear from patients on why they do not want to schedule treatment. If you were to take two weeks and write down every excuse you were to hear about why someone did not want to schedule their treatment, I bet that you would find a pattern of the same excuses over and over again.

Excuses are objections and objections are often just requests for help or more information. The following are common excuses we hear and how you can help your patients overcome them and get them back in your chair.

Objections to scheduling dental treatment will occur. The question is, “How do you overcome objections and get those patients back in your chair; today?”

“I am not in pain, so I don’t think it is really necessary”

Let the patient know that you understand how they feel. Most people are surprised to learn that pain is the last symptom they will experience with gum disease. This is why over 50% of adults over the age of fifty lose their teeth to gum disease, not decay. Also, when the patient is in the chair, show them the x-ray and point out where the decay is now and how close to the nerve it is. Show them how it may travel toward the nerve and cause extreme pain that may lead to a root canal and crown instead of the small filling you are recommending now. Creating urgency is important in this situation. You do not want your patient to ever be in pain, and you do not want to get a call on Saturday afternoon.

Let the patient know that that you are so sorry to hear that they have been ill. Send the patient a get-well card if the patient lets on that the illness is much more than a man cold. Put the patient on your call back in two weeks’ list. Give the patient time to heal, but do not forget to get back in contact with them. Chances are, you are not the only appointment they had to cancel due to being ill. Having a fuzzy head, they most likely won’t remember to call you back. Consider this exceptional customer service, to help keep track of their health needs.

“My tooth still hurts from the last time I was there”

Let the patient know that you are sorry to hear that and ask them to please share with you how they were hurt. Explain that It may be that she simply needs an adjustment on that small filling your doctor just placed. Explain the techniques that your office can provide to ensure this does not happen again. Then, be sure to put a note in the patient’s chart so that the clinicians will take extra care at her next appointment. Let her know that the doctor would like to see her right away to determine what is causing her discomfort.

“I can’t get out of work”

Remind the patient that most of your other patients have jobs as well. That is why you offer early morning and/or later appointment times. Let them know that you can schedule in advance so that they can request the time off of work. The patient must first understand the value of the appointment. Then they can verbalize to their employer that taking a couple hours off for a preventative appointment may save them missed days in the future.

“I cannot afford to pay for treatment”

Remind the patient that they can’t afford to not have the treatment done. Educate them on the risks they are taking by not having the treatment done. Then explain to them how you have been able to help other patients with this same concern. Review your payment options with them and be sure to give them a couple of options that they are comfortable with.

“My insurance does not cover it”

Explain to them how insurance is not meant to dictate treatment and even though their insurance does not cover it, the treatment is necessary in order to save their tooth or get rid of an infection. Show them the value of having the treatment done. Also explain to them that their insurance benefit not used for this procedure can be used for other treatment that is covered so they will not lose it. Do your best to explain insurance benefits to your patients. It is confusing for us professionals, imagine how confusing it is to your patients.

Remember, an excuse is most likely a request for more information, a way of asking for help. Next time you hear one of these excuses, remember this and see what you can do to help.

ABOUT THE AUTHOR: Coach Cindy Rogers, RDH, BS, OMT

For many years Cindy has been an integral part of successfully building dental practices from the group up. Cindy is known for creating a harmonious work environment where the whole team looks forward to coming to work every day. The result of this has been massive growth for the practice.

Her passion is to share her success and knowledge with other practices so that they can experience a great team working environment while watching their profitably explode. What you will experience with coaching by Cindy, is somebody that can bring your team together to create your ultimate dental practice, and the ultimate patient experience.

It is through her years of experience in the dental field and the methodologies of Dental Practice Solutions that Cindy creates the next level of success for each dental practice she touches. When not focusing of dentistry, Cindy spend her time with her family exploring the outdoors in beautiful Pacific Northwest. Schedule a profit boosting session today and find out how you can optimize your dental schedule. Contact Cindy: admin@dentalpracticesolutions.com