Dental Tribune U.S. Edition

Dental Tribune U.S. Edition | March 2012 A5 I am asked all of the time what the next big thing is going to be in dentist- ry. What new technology or technology is going to change dental practice? We certainly have made huge advance- ments in a number of areas, such as restorative therapy, implants and es- thetic dentistry. I believe the direction of the next great thing in dentistry is actually go- ing to take place in the oral-systemic connection. Most dentists are familiar with this connection as being how oral health affects systemic health. I’m going to look at the oral-systemic connection from a completely different angle — Facial esthetics treatment for every dental practice Now that the teeth look good, what about the peri-oral areas around the mouth? By Dr. louis Malcmacher Dr. lOuiS MalCMaChEr is a practicing general den- tist and an internationally known lecturer, author and clinician. He is the presi- dent of the American Acad- emy of Facial Esthetics www.FacialEsthetics.org. You can contact him at (800) 952-0521 or email at drlouis@FacialEsthetics.org, or you can visit his website at www.commonsensedentistry.com for more about Botox and dermal filler training and other resources. Fig. 1 Patient complains of her gummy smile. Photos/ Provided by Dr. Louis Malcmacher the oral-systemic esthetic perspective. We all can do a magnificent job of making teeth look great and giving people a healthy and beautiful smile. Esthetic dentistry has been an absolute boom during the last 30 years, espe- cially when it comes to such innova- tive techniques as teeth whitening and minimally invasive veneers like Cristal Veneers by Aurum Ceramics. Now that the teeth look good, what about the peri-oral areas around the mouth? If the teeth look good but we ignore the rest of the face, then we have really lim- ited what we have done in esthetic den- tistry. It is time to give serious consid- were likely not enjoyable, yours is a bet- ter team today because of them. Giving yourself and your employees permis- sion to be human and make mistakes, at least occasionally, may actually help to avoid bigger blunders in the future. Case in point, I recently had a conver- sation with a dentist whose collections coordinator accidentally charged a pa- tient $1,120 for a $120 procedure. The pa- tient called the office furious. The mat- ter would have been resolved at the end of the day, but at the time the patient was checking out, things were chaotic at the front desk. The dentist, unfortunately, got an ear full from the patient. During these stressful economic times, it’s easy to get upset and fly off the handle with employees when things go wrong. After taking it from the patient, he promptly ripped into the employee, which he later deeply regretted. In this case, both the dentist and the employee made significant errors; one was an accidental mistake, and the other was poor judgment. Nonetheless, it was an opportunity for both to grow personally and professionally from the experience. Fortunately, in the scenario above, the dentist did offer a sincere apology to the employee. They also looked at the patient check-in/check-out system to determine how bottlenecks could be addressed and pressure eased during hectic times. None of us enjoys making mistakes. Nonetheless, they are a fact of life and work. A “screw-up” party gives everyone a chance to acknowledge blunders, talk about them openly, offer creative solu- tions to help prevent them in the future and, most importantly, move on. Don't make this mistake Now let’s consider a more serious prob- lem in your practice that, unfortunate- ly, doesn’t happen just once in a while. In fact, it may be occurring daily, and it would be a grave mistake not to address it. What is it? Thousands of lost patients. Let me explain. Living in a fantasy I recently had a conversation with Dr. John. Like many dentists during the last couple of years, he’s experienced some challenging times. But one thing that Dr. John firmly believes is that his prac- tice is not losing patients. He is living in a fantasy. But Dr. John, a sole practi- tioner, is not alone in his delusions; he is like 78 percent of the 128,000 general dentists in the United States. The vast majority of solo-practitioner practices are losing more patients than they are bringing in, and many of them scoff at such a notion. Holes in the schedule? “It’s the weather.” Lower production? “It’s the economy.” Fewer hygiene days needed? “It’s the hygien- ist.” And the excuses go on; seldom will these dentists acknowledge that they are losing patients. We work with these” Dr. Johns” and “Dr. Janes” every day. Typically, they have been in practice for 15 to 30 years yet can’t quite explain why they are still solo practitioners. Some have had 2,000 to 3,000 people come through their of- fices and never return. The harsh reality is that such practices are losing more pa- tients than they are gaining. Dentists commonly believe that pa- tient records in the computer or in the files constitute active patients. In ac- tuality, only those patients that have been in the practice for a hygiene recall appointment in the past 12 months can be counted as active patients. The recall system, or lack thereof, is a huge factor in patient attrition. Yes, patient retention will vary from practice to practice, but it’s essential that you understand where yours falls. To measure patient retention, deter- mine the number of recall patients that are “due” for the month, with and without appointments on the first of the month. Put that number in a secure place. On the last day of the month, run a production/provider report for hy- giene and add the number of periodic exams and periodontal maintenance procedures performed for the month. This total equals the number of recall patients “treated.” Divide the number of patients “treated” by the number of pa- tients that were “due” and that percent- age gives you your patient retention for the month. Next, take a good hard look at recall. It is the most important system in the practice for ensuring patient retention; it’s also the most ignored system in the practice. How do you know if your recall system is weak? Look at the number of hygiene days. If they haven’t increased in the past 12 months, the practice is losing patients. In addition, the schedule has open timeslots; however, the schedule looks full because the practice schedules patients six months out. Moreover, no one on the business team is responsible for ensuring that the hygiene schedule isn’t riddled with holes or following-up with past-due patients. Effective recall system critical It is essential that if you pre-schedule patients six months in advance you educate the patients, and the business staff must follow-up with patients on the phone. Too often it’s the follow-up that falls down. In addition, when the patient is in the chair, communication between dentist and hygienist and with the patient must reinforce the need for ongoing care. Most patients don’t think they need to go to the dentist every six months, and many dental teams are not particularly effective in convincing patients other- wise. It’s not uncommon for the dental team to trivialize the importance of care delivered and confirm the patient’s misperceptions. An effective recall system includes other key components as well: The prac- tice is actively educating the patients. Professional recall notices are used as well as e-mail and text messaging. The patient is involved in the recall process by personally addressing the envelope that they will receive in the mail with their recall information and informa- tional brochures. A business employee follows up with patients to ensure they will keep their recall appointments. In addition, the hy- gienist is scheduled to meet specific pro- duction goals and there are never more than a firmly set number of openings in the schedule on any given day. Certainly, every dental team makes mistakes; however, there are some that are costing your practice far more than others. Fig. 2 Botox used to reduce maxillary gingival excess in a one-minute appointment. ‘The vast majority of solo-practitioner practices are losing more patients than they are bringing in.’ “ MISTAKES, page A4 ” See BOTOX, page A6 CLINICAL