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4.25.08 Issue #320 Forward This Newsletter To A Colleague

New Patients, New Treatment Opportunities
by Sally McKenzie CEO
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Do you remember when it first occurred to you that patients were actually choosing to come to you? They might have received a referral from a friend or family member who was bragging about you. Maybe they were impressed with how you transformed a co-worker’s smile. Whatever the reason, the bottom line was that they wanted to come to your office, and it was rewarding to know that they chose your practice.

New patients present a host of opportunities for dental teams to truly shine… as well as fail miserably. The manner in which your office establishes an excellent positive relationship with every new patient from the first phone call to the time they drive away will set the tone for long and rewarding practice/patient relationship.

In working with dental teams through our Treatment Acceptance Training Program, we find that many have a system for how they handle new patient visits but few give much thought to creating an environment in which those new patients willingly and happily accept and complete recommended treatment. Oftentimes, they give little consideration to what today’s patients are expecting.

Many patients today expect more than just a routine visit. They are smart, savvy and much more aware of advances in dental care and treatment options. Numerous patients would love to change something about their smile or improve their oral health but few will verbalize those desires without prompting. Others have concerns but don’t want to appear foolish by raising them. Yet if new patients feel that the doctor and dental team are sincerely interested in their needs, wants and concerns, they are far more likely to be open to the treatments recommended. Follow these steps to set the tone for new patient treatment acceptance:

  • Create a comfortable, non-rushed environment when explaining treatment. Don’t have the schedule booked so tight that you are perceived as being in a rush. Patients need to feel that they are important and worthy of your time.
  • Explain in simple language the reasons procedures are necessary. Choose language that fits the patient’s educational level of understanding and speak slowly, using pictures to illustrate.
  • Explain the steps of the procedures, and how many appointments and how long each appointment will require. Explain to the patient how you will make her/him comfortable during treatment and what options are available, such as anesthetic.
  • Ask the patient questions to determine if the patient has any false ideas about treatment. (Many patients still think that root canal therapy involves removing the roots.) Use educational tools, like video or other visual aids. When using video or other educational aids, summarize what the patient has viewed and ask if there are any areas that need further explanation.
  • Be empathetic to the patient’s concerns about the condition of the teeth. Don’t make him/her feel that his/her mouth is a “mess.” Patients who have postponed dental care are often embarrassed and don’t want to be perceived as neglectful or hopeless. Encouragement coupled with kind words can build trust and respect.
  • Explain alternatives to the treatment. Make sure the benefits and the possible risks to the procedures are understood. Informed consent in writing is necessary when there are risks and when the outcome could be less than favorable.
  • Look the patient in the eye when discussing treatment. Sit at the same level as the patient and lean slightly forward to show interest and care. You will be able to listen to and observe the patient’s response more readily.
  • Smile and nod your head in understanding as the patient responds to the presentation. This is proof to the patient that you are truly listening to each word said.
  • Never turn away from the patient while he/she is speaking. Not only is this rude, but it also shows that you are not listening to what the patient is telling you.

Presenting treatment to patients requires skill and understanding of patients’ needs. Many people learn these skills by trial and error, which can be quite costly. If treatment acceptance is a struggle among either new or existing patients, or both, it’s time to find out exactly where this critical system is breaking down.

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Dr. Nancy Haller
Dentist Coach
McKenzie Management
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How One Team Is Conquering Team Dysfunction: Part Two

Last October, I had the privilege to work with a savvy dental leader and his team. Although the practice was productive, he wanted to take the business to the “next level.” A two-day team retreat was a sizable investment, but he knew that employee performance is directly correlated to practice profitability. In other words, the purpose of training was business-focused, not just a feel-good reward. The team with whom I worked showed tremendous courage and discipline. My prediction was that they were on their way to “extraordinary levels of success.” Here’s the six-month update. It starts with an email I received from the Office Manager, “Mary” (the names of the dentist and employees are not real names).

Hi Nancy, We have transitioned through our office remodel and the digital equipment! (We made it!) We have added a second hygienist 2 days a week and hope to add a third day this summer. Our current second hygienist can only work 2 days a week and we are interviewing for a third one in June.

It's just in the past few weeks that everyone is really starting to relax and have fun again. (You know how rocky transitional periods can be). The office turned out beautiful, the team is comfortable with all the new digital chairside technology. The practice is growing—we are averaging about 50 new established patients a month. Dr. Smith is booked out farther than he has ever been, as is the hygiene department. Julie is diligently applying the calculations she learned at the hygiene training. Attending your classes really helped us to communicate much more freely. We refer back to the information frequently. Especially the "triangle.”

[For my readers, the following is an example of a “triangle”: Marla the hygienist is angry at Ann the chairside because Ann didn’t clean up her trays before she left the office. Instead of talking directly with Ann, Marla vents to Jane (who dislikes Ann) because Marla’s intent is to have someone join her in feeling angry at Ann and she knows that Jane will agree with her. No positive outcome will occur as a result and lot of emotional energy is wasted. Relationship back-biting worsens and practice productivity is sabotaged.]

My question for you is: Even though we refer to the workshops often, have the Mission Statements posted, and things are going well, where do we go from here?

Here’s my reply, and hopefully some ideas to strengthen your team.

Hi Mary, Time flies! During the two days we spent together, you came to know one another in a deeper, more meaningful way. You created strategies for making your working processes more productive.

First and foremost, CONGRATULATIONS on all the accomplishments…

  • surviving an office remodel
  • adding new members to your team
  • learning new technology

I’d say that was cause for celebration. Therein is my first recommendation—the team needs to honor the successes you have achieved.

It could be something simple like ordering in a six-foot subway sandwich and having a two-hour lunch to relax. Or it could be a more elaborate fun-day when you all go bowling and have pizza. It should be a group activity. Although I love spa-days, those are individual rather than team-oriented.

Regardless of how you decide to mark your achievements, set aside time within the activity to talk with one another. Everyone should answer these two questions, beginning with Dr. Smith:

  • What did I do to help the team succeed?
  • What did I observe teammates doing that enabled the group to succeed? (Everyone needs to verbalize at least one compliment about themselves and one compliment about every other member of the team.)

As you consider the next steps, discuss the following:

  • What are the team’s strengths?
  • What does the team need to learn (or do differently) to achieve (or maintain) the practice missions?

Be as specific as possible about the behaviors you did or the actions you observed in teammates. I encourage each of you to continue to invest in building a stronger, more cohesive, more productive team. With a little extra attention, everyone will yield even greater results.

I hope you will keep me updated about your team progress. Until then, I send warm regards. Nancy

Dr. Haller is available for team building and dental leadership coaching. She can be reached at

Interested in having Dr. Haller speak to your dental society or study club? Click here.

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Carol Tekavec
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Talking to Patients about Implants

Implant dentistry is a proven treatment option for patients with missing teeth. However, many people do not understand what an implant is or how it functions. They may have unrealistic expectations of what implants can do for them, or they may be so afraid to have one placed that they turn down a chance for a true improvement in their lives. Your patients may be candidates for implants. What do they need to know and how can you talk to them about their concerns in regards to understanding dental implants?

Patients need to understand why missing teeth should be replaced in the first place! Most people would not want to have a tooth missing where others could see. What about missing teeth in the back of the mouth? A large number of people do not know that along with affecting appearances, any missing tooth can affect the health of the mouth and the way that the rest of the teeth fit together. They do not realize that teeth on either side of an empty space may tilt into that space, or that teeth opposite an empty space can drift up or down into the opening. Remaining teeth can also become loose, start gum problems or even cause headaches due to altered biting forces. When a tooth is lost, the bone that used to support that tooth may also start to disintegrate. Teeth and tooth roots give the jawbone a “purpose.” Without them, the bone in the jaw may decline. Choices for replacing missing teeth include bridges and removable partial dentures, both tooth-supported and implant-supported.

Patients need a simple definition of an “implant.” An implant recreates the anatomy and function of a natural tooth. Although there are many styles and brands on the market, patients really just need to understand that there is a portion of the implant that goes into the bone and acts like a root, and a crown that is placed on top that looks and “acts” like a tooth. Implants can be used to support replacements, like bridges, but they can also be used to take the place of a single missing tooth. With implants, teeth next to a space do not have to be trimmed down to hold the fake “fill-in” tooth or teeth. Having an implant may also contribute to a certain amount of bone longevity. Since an implant integrates into the bone, it may give the jawbone a “purpose” and help it to not deteriorate.

Patients also need to understand that in most situations the surgical placement of an implant must be accomplished and healing must occur before a crown or any replacement can be used. A patient will be concerned about how his/her mouth will look while this healing takes place, so explain any temporary device you will provide. If your office places implants that can be loaded immediately, be sure your patient understands how to care for the implants and “crowns” before the next visit to you.

Is the treatment painful? Your patients want to know! Instead of beating around the bush, it is usually best to face this question head on, and with honesty. The placement of implants requires surgery, and though most patients will be comfortably numb during the procedure, they are likely to experience discomfort afterwards. Tell your patients what to expect and how you will take care of them, and encourage them to ask questions.

Patients want to know if their insurance will pay for implants. More and more benefit plans are including implants in their contracts within the confines of their applicable yearly maximums. Most yearly maximums are about $1,500–$2,000, so insurance may be somewhat helpful in paying toward implants. Some plans stipulate a “least expensive alternative treatment,” meaning that the carrier may only pay what they allow toward a non-implant supported, removable partial denture or full denture. If the patient’s contract specifically excludes implant procedures, they will not be covered no matter what a patient or dentist may request. Under some contracts, the implants may be denied, but the crowns or bridges placed on top of them may be covered. Implants may also fall under a dental “pre-existing” clause. Such clauses are not as common as they once were, but some plans still specify that for a replacement of any kind to be considered; at least one of the missing teeth to be replaced must have been lost or removed while the patient was covered by the existing plan.

It is important to check with the patient’s plan prior to placement of implants so that any financial concerns are dealt with before patients get the bill. Understanding the correct way to use the dental insurance codes will help the patient to maximize insurance coverage.

Carol Tekavec, CDA RDH is the president of Stepping Stones to Success and a practicing clinical hygienist. She is a speaker with the ADA Seminar Series, has appeared at all major dental meetings and has been featured in Dentistry Today’s “Top Ten Clinicians in Continuing Education” for 9 years. She can be reached at

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