5.30.14 Issue #638 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter
 


Carol Tekavec, RDH
Hygiene Consultant
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Your Fees are Too High!
By Carol Tekavec RDH

A common complaint among patients is the notion that dentistry is too expensive. It is likely that if you asked any group of dental patients sitting in any reception room in any part of the country if their dentist charges high fees, they would probably say yes. I have had conversations with patients that go something like this:

Hygienist: The dentist recommends placing a crown on the tooth we talked about. It has a cracked filling and one of the cusps has also been broken off. 
Patient: A crown! Can’t he just replace the filling?
Hygienist: More than just the filling has been damaged. The filling is cracked and leaking and the cusp is broken off. That is why you feel that sharp edge and discomfort in the area. A filling can’t be used because there is not enough of the tooth remaining to hold it in place. A crown covers the top and sides of the tooth and replaces the broken-off cusp. It restores the tooth to the function that you had previously.
Patient: Well, what does a crown cost?
Hygienist: A porcelain crown, which will be fabricated here in our office while you wait, runs around $1,200. (Fee just for this example)
Patient: Over a thousand dollars for just one tooth! That is outrageous!

Hygienist: Well, when you think about it, the tooth that is being crowned emerged in your mouth when you were six years old. You are now fifty-six. That tooth has been doing its job for you for fifty years. To keep that tooth doing its job, it needs a little help. A crown can do it. With reasonable care, a crown can help that tooth last a good long while. Years in fact. Just think about the cost of a good pair of running shoes. Those shoes take a beating, and you do not expect them to last more than a few months. A crown can last years, taking much more stress than running shoes. Plus a crown is made for you individually. It is custom made, not assembly line made. Without a crown the tooth will continue to break down, perhaps even allowing bacteria to get into the pulp chamber inside the root, eventually causing an infection. Then our choices about what to do go down. You might need a root-canal plus a crown. This would be about three times as expensive as a crown alone.
Patient: Well, I could just have that tooth extracted then. That sharp edge isn’t bothering me that much right now anyway.

Hygienist: Having such an important tooth extracted is a last resort fix under current dental thinking. A series of events can happen after a tooth is extracted. The opposing tooth can super-erupt, and the teeth on either side can start to tilt. Our teeth work together inside our mouths, like gears on a bicycle. Remove a section of the gears, so to speak, and our teeth cease to function properly.
Patient: I could have the tooth extracted and just get an implant. I hear commercials on TV all the time about this.

Hygienist: Yes, implants are a good solution in many cases, but compared to the cost of a single crown, they are more expensive. You have the cost of the implant and then the cost of the crown on top of that.
Patient:  Well, I will just have to think about this. The cost of a crown is really high! My wife and I have a trip to Europe planned in two months, and we just finished redoing our kitchen and bathrooms. 
Hygienist: You can let us know if you decide to schedule your crown. All the information is in our computer. If the tooth breaks down further it might be hard to have it fixed when you are on your trip.

Will the patient call back to schedule the crown? He might, or he might not. Should the hygienist have pressured him to set up an appointment? In my opinion, no. He can always simply call and cancel if he has not really accepted our advice.

What can we do when a patient expresses that he thinks the fees for dental treatment are too high? Going through a conversation like the one above at least opens the door to thoughtful consideration on the patient’s part. Explaining that crowns are custom made for each person can also be explored using the analogy of going to a tailor for an individually made suit, as opposed to buying one at Sears. Plus the fact that there are no mass-produced crowns in the first place!

Bringing up the fact that dentistry is performed by a trained, licensed, professional may also help. Trained professionals have standards that patients usually understand. In most cases they appreciate that what takes place in their mouths is important to their health, comfort and appearance. Getting a crown placed is not like buying a tee shirt!

Always keep in mind that regardless of the fee, a patient will likely think that it is high. A competitive, reasonable fee must be determined by the dentist, and the staff should be comfortable with it. If a patient is satisfied with his treatment he will usually tell others, “My dentist is expensive, but he is good.” 

Right or wrong, dentistry sometimes has to compete with other types of spending. Fees need to reflect the service that is being provided, despite the fact that patients may sometimes balk at the fee. Doing our best to place the importance of dental treatment in patient friendly terms can help them understand that their dental care deserves careful consideration.

Carol Tekavec RDH is the Director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office.” Interested in knowing more about how to improve your hygiene department?  Email hygiene@mckenziemgmt.com.

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