6.29.07 - Issue # 277 Forward This Newsletter To A Colleague

Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Pre-Selling Dentistry, or Educating Patient’s?

What exactly is pre-selling dentistry? So many times I have heard hygienists make the comment that they do not feel it is their job to sell dentistry. Let’s take a look at the difference between pre-selling dentistry vs. selling dentistry.

  • Pre-selling or selling dentistry may also be termed:
    Informing the patient about their mouth
    Educating the patient
    Pointing out opportunities
    Planting a seed
    Making a suggestion

Many hygienists, once it is placed in one of the above terms, will say, “Oh, yes, I do that all the time.”  

For instance, when the hygienist picks up the mirror and probe or explorer to check around for suspicious areas he/she notes in their mind that #3 has a large old filling but it is stable, and looks at the tooth that is missing in the upper left quadrant, #14.

This patient has treatment pending for either an implant in the space where #14 is missing or option number two, a bridge. The doctor has gone over the options with him at a previous appointment. However, the patient has not accepted the current treatment and nothing else has been treatment planned.

Many hygienists will remind the patient of the need for the treatment that is pending, but there are also many hygienists that will proceed with the prophylaxis, not mentioning anything to the patient. The reasoning in their minds is that they do not sell dentistry or “it is the job of the dentist, I can’t diagnose treatment.”

It is true that hygienists are not legally allowed to diagnose treatment needed. However, the hygienist is allowed to educate their patient about what they see in the mouth when it comes to what may need to be done by the dentist.

For example the hygienist may say to the patient in the above scenario, “Mr. Jones, you have a very large old filling in the upper right, #3.  It looks all right to me at this time. When it does need to be replaced, doctor will probably want to do a crown on that tooth, but we will have doctor take a look at it. I also noticed that you have treatment that needs to be done in the upper left area where this tooth is missing. What have you decided when it comes to your options?”  Now, give the patient time to answer.

In this verbiage, we made sure that when the treatment pending is brought up to the patient it is in the form of an open-ended question. We do not want to ask, “Have you decided what you want to do in the upper left area?” This only leads to a yes, no answer. When the patient is given an open-ended question it will lead to more conversation in a natural occurring way, enabling us to do our job without a nagging approach when it comes to the patient’s perceptions.

In this scenario, it has also set the patient up to hear from the doctor that they need a crown, while if the patient does not need a crown it will not be embarrassing to the hygienist when the doctor simply states, “I do not feel that tooth #3 needs a crown at this time but we will check it at your next professional hygiene appointment.”

Many things happened in this two minute conversation, because the hygienist tends to have the patient rapport, it is nice for the patient to hear from the hygienist that he may need something done before the doctor ever walks into the room. Also, the more often a patient hears that there may be something wrong the more trust that is developed.

Now, if the patient did not need to have it done at this time. What next? The hygienist should make a note to, have doctor check #3 at the next professional hygiene appointment, it may need a crown in the patient’s record. This will also be the hand written note that will be placed on the patient’s invitation style recall card. Thus, creating a need to return other than to just get their teeth cleaned. Now, the patient has something that may be failing on them at any time.

When the patient is due to come back in six months, the personal note that was written on the invitation style recall card sent to the patient is also available for the Scheduling Coordinator when she talks with the patient. Having this note available allows the Scheduling Coordinators to remind the patient that not only is he having a professional hygiene appointment, but doctor will also be checking the upper right as there is a large old filling that may need to be replaced.

When the patient comes back in six months, the hygienist will inform the doctor at the morning meeting that the patient needs to have #3 checked for a possible crown. When the patient is in the hygiene chair, he will be told, “I am going to have doctor come in and examine the tooth on the upper right which is tooth #3. We are monitoring that large filling you currently have as it will need a crown when it does need to be replaced.”

Using the actual tooth number along with the location in the patient’s mouth allows them to make a mental note so when it needs to be done he will think, oh yes, #3 I remember that being mentioned in the past.

If the patient now needs the crown on tooth #3, he is more likely to accept treatment. Sometimes the patient may not need the crown for a year or two. So, it is being checked at every recall.

Not only is pre-selling and selling dentistry important to the doctor and the entire team but it is equally important to the patient. The patient should be educated and know exactly what is currently going on in their mouth and what the future may bring based on the current condition of their mouth.

Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.
Interested in having Jean speak to your dental society or study club Click Here.

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