By: General Dentist Donald Gundlach

Fluoride is one of the most discussed topics when it comes to the world of dentistry. You’ve probably heard a bit on both sides of the spectrum: one, that fluoride is not necessary, and the other, that fluoride is good for your oral health. 

Here’s the truth: when used correctly, fluoride does not pose a threat to overall health. Instead, it provides a benefit to oral health and aids in preventing cavities.

What Is Fluoride and Where Does It Come From? 

Fluoride is a natural mineral found in soil, water, and foods. It is both common and abundant in nature. Synthetic fluoride is produced to be used in drinking water and dental hygiene products such as toothpaste, mouthwashes, and various chemical products.

What Products Contain Fluoride?

Fluoride is found in dental products, such as toothpaste, mouthwashes, some floss, cement & fillings, gels, and varnishes. Many products are fortified with fluoride because of its ability to prevent tooth decay by about 20-40 percent, according to the American Dental Association, and reduces cavities in patients of all ages. As a result, the use of fluoride can save time and money due to costly procedures to restore teeth damaged by decay.  

Fluoride in Water

In many areas, water fluoridation is also used to help curb dental problems. In a study by Cochrane, when fluoride was added to their water supply, children experienced 35 percent fewer decayed, missing, or filled baby teeth and there was a 15 percent increase in children with no decay in their baby teeth.

How Does Fluoride Work?

Fluoride works to prevent tooth decay by…

• Changing the way enamel develops in children under the age of 7, making it more resistant to acid attack
• Creating an environment where better quality enamel is formed, assisting in resistance to acid attack
• Reducing the ability of bacteria in plaque to produce acid

All these benefits help protect and strengthen tooth enamel to prevent tooth decay and costly dental issues down the road.

Are There Risks Associated with The Use of Fluoride?

Like any substance you put into your body, moderation is key. While it’s proven that fluoride is beneficial in reducing tooth decay, there are side effects of ingesting too much fluoride. 

For most of us, we don’t have to worry about consuming too much fluoride because of regulations in the fluoridation of water and the safe amount used in dental hygiene products. The most common side effect of fluoride is temporary white spots or streaks on teeth with high fluoride exposure. This does not harm the teeth and is instead considered a cosmetic concern. These marks often disappear over time.

Small amounts of fluoride are unlikely to be dangerous and over 100 national and international health and other organizations recognize the benefits of adding a safe amount of fluoride to water and dental products.

Should I Use Fluoride?

The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) have different standards of how much fluoride can be put into water to protect teeth in a safe manner, but we know that each regulation protects individuals from being harmed by too much fluoride. In the U.S., we take direction from the CDC, as international organizations such as the WHO have worldwide standards that are often not as strict as in the U.S.

Overall, the guaranteed benefits outweigh the potential risk, and we should consider fluoride our friend. 

If you’re concerned about fluoride treatment at the dentist, feel free to ask your dentist about ways to protect your teeth from decay. Using toothpastes, mouthwashes, and other dental hygiene products that contain fluoride is a great way to start.

For more information on the healthy use of fluoride, schedule an appointment below or call your local Dental Associates clinic.

Despite advances in dentistry, dental anxiety remains a problem for many. Research in the January 2013 British Dental Journal found that roughly 36 percent of the population experiences dental anxiety while 12% experience extreme dental fear. In efforts to mitigate anxiety, a new business concept — dental spas — is rapidly growing and creating a new face of dentistry.

Distinguishing fear, phobia and anxiety
While “dental fear,” “dental phobia,” and “dental anxiety” are often used interchangeably and aren’t necessarily isolated events, it is important to distinguish the terms. Fear is a reaction to a perceived threat, such as the high-pitched sound of drills at a dental office. Phobia — persistent and intense fear — in a dental setting is known as odontophobia, which can lead to “feelings of hypertension, terror, trepidation, and unease,” according to the March 2016 issue of Clinical, Cosmetic and Investigational Dentistry. Anxiety is the emotional reaction to an unknown danger and/or before the threatening stimuli is encountered. Dental anxiety is common enough across various societies to be considered a general public health concern.

Cycle of dental anxiety
Dental anxiety is not simply an emotion that negatively affects a patient’s dental office experience. Anxiety has long-term implications that, left unchecked, can lead to a vicious cycle of dental anxiety. Patients with dental anxiety delay dental care out of fear, which causes further deterioration of oral health.

Finish reading this article in the August issue of Contour magazine.

~Jane Lee, Houston ’23

By Dr. Lawrence Spindel DDS

Patients often come into the NYU School of Dentistry, where I teach with “emergency dental procedures”… They often have a particular symptom that is bothering them. The students often want to address the symptom immediately, but often they are required, in non emergency situations, to first do a comprehensive exam and treatment plan. 

It is not usual for these new patients at the school to initially express a resistance to taking a full set of radiographs and submitting to a full work up by that student. Quite often their student dentist will also want to immediately care for the tooth that’s bothering them, but although many patients come to our school to take care of the one problem that is bothering them, it’s very important that our student dentists understand the need for the performance of a complete patient assessment prior to performing the non emergency dental treatments.  Many problems that patients have are not terribly symptomatic, at least until that time when their conditions worsens and they are forced to seek “emergency care”. For this reason and others, most of our emergency treatments are palliative in nature and not definitive care.

Obviously, if a patient is experiencing an acute infection or a tooth that is causing significant pain, something should be done for them to alleviate their “acute” problem, but once they receive emergency treatment, it’s the dentist primary responsibility to evaluate their patient’s entire clinical situation.  As general dentist, we should always assess our patient’s overall condition and come up with a treatment plan, or multiple different plans that might be appropriate alternatives. This is principal that our students need to embrace, even when their patients maybe initially resistant.

A patient may say, “I am here to address this one tooth that’s bothering me and nothing else for now, but on the occasion that I’m in attendance, as the supervision, charge with the responsibility, for overseeing their student’s treatment, I engage the reluctant patient and explain that often dental problems are initially not overly bothersome but can be serious enough that they need to be addressed as well. Also, dental treatments can be expensive and patients should be aware of their overall problems before committing funds to treating just one tooth. Many patients actually have multiple problems that may influence the types of treatment that will ultimately be chosen. Teeth that have infections and/or large carious lesions may need multiple costly procedures to remedy and if multiple teeth are similarly involved, a patient needs to become aware of the extent of their problems, before deciding on expensive treatments to save just one tooth. After all patients have multiple choices to make, and options when they’re deciding which teeth should be saved and which should be extracted.

Once I explain this to patients, most tend to relax, especially after I point out that no one can force them to have any particular proposed treatment.  Still it is our duty to perform a comprehensive examination to determine the extent of their problems,  so that they can make an informed decision, concerning their subsequent treatment. Since no one can “force” them to have treatment, the “worst”case scenario is that our school may not provide the particular treatment they desire, (because in our opinion, it’s not in their best interest and we try to “do no harm” to our patients), but they’ll still be free to seek a second or third opinion elsewhere. 

Porcelain crowns and veneers 19 year post op

 Most patients seeking a better smile seek guidance from their dentists on how to improve their smile. Most are already familiar with porcelain veneers since they have friends or family who have chosen this route. The esthetic results are often determined by the lab and the dentists mission is to prepare and impression their teeth properly. Usually the lab provides a cosmetic wax up done over the patients study model. This wax up can be used to dress rehearse the case prior to tooth preparation and can be used to fabricate good looking temporization as well. At least some of the esthetic decisions are determined with the help of the lab. 

Patients seeking a treatment plan by a dentist about cosmetic dentistry would probably do best if they find a dentist equally familiar  with doing both esthetic restorations with composite as well as performing makeovers using veneers. Often the resulting veneers look good, but somewhat “fake”, since the restorations tend to be more monochromatic that natural teeth and have somewhat stylized carvings. Digital designing can sometimes improve the appearance of the carvings since digital lab designers can sometimes use a digital library of  good looking natural teeth to help design and mill their restorations, but this is not possible if the veneers have an outer layer of feldspathic porcelain. Feldpathic porcelain is usually the most esthetic ceramic material, but it is usually shaped and carved by a ceramicist in an “analogue” manner. This makes the appearance dependent on the skill of the ceramicist involved. 

Many patients could benefit from good looking direct composite restorations, especially if they are more or less happy with their teeth but have small areas that need repairing or need small additions. When these are done properly the resulting restorations can greatly enhance smiles with minimal or no preparation of the patient’s teeth. The results often do not alter the overall shape and character of a patients smile, just enhance it. Their friends may not even know what was done. They will only observe that their friend’s smile is looking good! In my mind, this is the best that esthetic dentistry can offer, since the patient doesn’t lose the look of their smile, but just enhances it. 

Another advantage of direct bonded composite restorations vs porcelain veneers , is that they are easier and less expensive to replace or repair. Since nothing lasts forever, this most likely will eventually become necessary, regardless of which type of restoration is chosen. 

There are many instances when porcelain veneers are the correct choice for a smile makeover. Adding overall length, changing the color of a smile without bleaching or when extensive additions are needed, porcelain veneers or even full crowns may be the best choice  Obviously, for those contemplating a smile makeover, their best option is to visit a cosmetic dentist versed in all types of esthetic procedures so that they can be fully informed about what option is best to improve their particular smile. 

By Chandra Chakravarthi

For most people, there’s at least one ongoing task or project that causes stress at work because there isn’t an easy way to do it. For the front office team, this task is usually dental scheduling.   

Scheduling dental appointments is a critical but time-consuming task. It can be done in an efficient way so that you and your team can spend more time on other tasks that you enjoy.  

How do you handle dental scheduling? 

Here are five ways to make dental scheduling a hassle-free experience for you and the front office team.  

1. Use your ASAP list. 

Your ASAP list should be the first item you use when filling appointment gaps. These patients have expressed interest in coming in sooner if an open slot appears.  

If you don’t already have an ASAP list in your practice management system, then use it to build your list. You probably have several patients who are willing to come in earlier. You can even give patients a way to opt-in to this list. Consider including this opt-in request in the patient intake forms and during the check–out process.   

You’re more likely to reduce stress and successfully fill your schedule by contacting patients on the priority list first. And patients will appreciate you moving them up leading to increased patient satisfaction.  

2. Expand your communication methods. 

Meeting your patients where they are is critical in creating a positive dental patient experience. Your patients have different communication preferences in each aspect of their lives. Giving your patients options and asking how they want to be contacted is one way to be more efficient around scheduling.  

Additionally, it’s good to consider what’s manageable for you and your team. Look for ways to automate your communications. This way, you’re using your time in the best way possible while still meeting patients’ expectations.  

3. Develop a communication plan for appointments.

Do you have a patient communications plan, or have you envisioned one but are too busy juggling multiple tasks to create one? While this might seem like a daunting project, you and your front office team will reap the benefits in the long run.  

It doesn’t have to be a fleshed–out plan. Here’s what to consider first, and then you can keep adding to it.  

Start with what types of communications you already do and how often you want to reach out to patients.  

Additionally, here are a few other items to evaluate. 

• Have you asked your patients their communication preferences? 
• Is there an easy way for them to opt-in for certain messages? 
• Have you considered experimenting with different content formats such as video or a newsletter? 
• Do you use social media? 
• How far in advance do you want to reach out?  

Remember your outreach can impact a patient’s view of the practice.  

Communication is an effective way to bring in new patients and convert them to lifelong ones. Download our eBook the Ultimate Dental Practice Marketing Retention Guide for practical ideas on how to increase patient retention.

4. Offer teledentistry as an option.

Teledentistry is another avenue to remove friction in dental scheduling. It increases appointments by making them more accessible to current and potential patients, and it aligns with how many of your patients prefer to communicate. This could serve as an alternative if a patient is unable to come in person. 

Additionally, there are some use cases where a patient may not need to visit the dentist in person. And you can always schedule a follow-up appointment if an in-person visit is necessary. 

If you decide to offer teledentistry, then have a conversation with the entire dental practice team to determine what scenarios this can be used, the costs, and how to replicate a positive patient experience in a virtual setting.  

5. Use your social media channels to schedule dental appointments.  

Social media helps you to share practice information with your community, like having appointment availability. If your practice has active pages, then why not use them to encourage patients to schedule their dental appointments online? This is a quick and easy way to get the word out and can save you time from making individual calls.  

Posting on social media may not work for every practice. You need to know your patient base and where they get their information.  

However, if you have an active following and regular engagement on your social media posts, then consider posting about appointments on there. You can include a link to make the appointment and include the practice’s contact information. If a patient is interested or has questions, they can call or email your office to ensure HIPAA compliancy.  

At the minimum, this is something worth testing on your social media pages if you haven’t done so before.  

6. Schedule the next appointment as soon as possible.

Depending on the appointment type, you can schedule the next one when the patient is checking out. This is easier and more efficient than waiting on them to schedule their next appointment. And, always explain why they need to return. Education is critical in ensuring patients feel comfortable scheduling their next procedure before things get worse. It’s part of building that trust between you and the patient.   

For the noncommittal patients, you can emphasize that securing an appointment sooner gives them more scheduling options to choose from.  

Dental scheduling is impactful, so it should be handled in the most efficient way. You can keep your schedule full if you have a detailed plan in place. It takes a little time to get the process right, but once you do, it will result in fewer headaches. And you can spend more time on other tasks and creating a better in-person patient experience.  

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Keeping your appointment schedules full is just one aspect of your multi-functional role! Patient retention is also a critical part of maintaining the practice. Download our eBook the Ultimate Dental Practice Marketing Retention Guide to get more tips to increase patient retention through communication. 

By Steve Diogo

Clinical excellence is the foundation of every successful dental practice. But effective communication is the archway that leads patients to your practice, sells the treatment and services you offer, and builds loyalty. And communication, like clinical skills, can be improved with technology.   

Today’s best communication tech for dental practices features three critical elements: integration, flexibility, and ease of use. From cloud-based phone and email systems that automatically fetch patient information from your practice management software, to integrated 2-way texting and teledentistry, dental teams have never had more ways to connect with their busy, on-the-go patients to improve scheduling, reduce no-shows and boost case acceptance.   

In this post, we’ll highlight the powerful, affordable tech that can empower dental teams and improve communication to drive healthy schedules and improve treatment acceptance, all while streamlining workflows and lowering overhead.  

Want to read this later? Download the Dental Tech Brief: Phone Systems to discover how the right technology can move every patient conversation toward action.  

Here’s what you can expect from the best dental practice phone systems.   

Smart phone? Try genius phone.

With all the equipment, materials and technology in your practice, you probably don’t spend too much time thinking about your phone. Pick it up, make a call. Most likely, leave a voicemail. So unless it breaks, there’s not much to think about.   

It’s time to change that. Today your phone system can give you more control over your schedule, more flexibility in your day, and more information to have more productive conversations with your patients.   

Today’s best dental phone systems are smart communication hubs that provide powerful features and deep integration with your practice management systems. This integration allows you to immediately access real-time patient information on every caller, such as upcoming and past appointments, treatment plans, personal notes, and even payment history.    

RevenueWell Phone, a phone system designed specifically for dental practices, integrates with your practice management software to automatically display patient information on your computer screen when a patient calls. Think of it as a supercharged caller ID. Having this information in front of you means you can focus on the conversation instead of searching for it while you’re talking. That ability to focus, combined with the critical information you need, means you’re much better equipped to turn that phone call into an opportunity to schedule treatment or prompt your patient for payment on her balance.

Flexibility and ease of use

You have enough complexity running your practice on a daily basis. Your phone should simplify that complexity, not compound it. Many practice teams have implemented VoIP phone systems that promise ease of use, but in fact require assistance to manage the backend software that runs them.   

RevenueWell was determined to change this when it released its new dental phone system.  RevenueWell Phone features a simple interface that allows dental teams to quickly customize outgoing messages, call routing rules, and special messages and handling for lunch times, holidays, out-of-office rules and more. All can be changed with a few mouse clicks in its intuitive software. The system’s mobile app allows dental teams to access and manage the system any time from anywhere, providing dentists and teams with unbridled flexibility.  

Finally, support is a critical issue when considering a phone system. As the lifeline of your practice, your phone system needs to work optimally. RevenueWell backs its new phone system with its industry leading white-glove support, so teams can quickly get up and running with no stress.   

RevenueWell Phone ushers in a new age of practice communication, one in which you have the information you need when you need it without having to look it up. That means you can focus on the conversation—not the keyboard—and drive more productive and profitable conversations with your patients.   

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Editor’s note: This is the eighth article in a series exploring the business aspects of the dental profession, from starting a practice and marketing to hiring staff and finances.

Dr. Deshpande

A lot of us are thinking of buying a CEREC system in our brand-new office, hoping it make things efficient. We also consider getting the fanciest massage chairs for patients to use. You know what most patients really care about? Being attended to in time and being appreciated and cared for by our staff. Read below to read about two technologies that are already in every office but may not be used to their maximum advantage.

Phones

Did you know that many phone calls get missed by an average dental office? Did you know the most common time patients call to schedule appointments? Do you know what it costs for you as a practice owner to not know the above numbers?

Many practices spend a lot of money on marketing and getting the “right patient” in the door. Most patients will first check your online presence: your website and read your bio, then they check reviews, and finally, they’ll pick up the phone call and make an appointment. What if nobody picks up the phone on the other side? What if the patient leaves a message and does not even have it returned?

Guess what, by the time you figure out what happened, that patient called up another office and has an appointment on Monday.

1. What gets tracked, gets done. Consider having a phone tree — to have phones directed to the right person in your office — so the phone isn’t tied. Insurances, emergencies or billing, are three possible categories in a phone tree. Do you know which category will have the longest call?
2. Invest in a software that allows you to record each phone conversation (check if your state allows it first), transcribe VM’s, and that helps you audit your front office member’s personality. It is so important to have someone cheerful and happy answer new patient calls.
3. Make sure there is someone manning the phone at all times. Like most of our patients, I too, frequently make appointments for my chiropractor, personal physician and dentist during my lunch hour — 12-1 pm, on a weekday!
4. Maybe you couldn’t pick up the phone. Fine. Ensure your scheduler reviews all VM’s at the start of the next day and gives everyone a call back. They should do the same for all no shows, or late cancels too.

Scheduling

1. Ever thought of your perfect day in dentistry? It actually does exist. Every dentist has a different way of doing things, and the great thing about this is that in most scheduling systems you can input your own specifications. I, for example, like to complete root canals, implants or fillings at the beginning of the day, extractions right before lunch, and new patient exams or child prophies at the end of the day. One of my pet peeves is a quadrant filling at the end of the day. Figure out what is your way of doing things and tell your front office how you’d like them to schedule for you. This is your office after all.
2. Many business gurus agree that providers shouldn’t have unnecessary breaks in the day. While I agree with this thinking, it does not have to apply to everyone. Paint your own perfect day and try to make each day amazing.
3. One of the front office managers I used to work with told me that the thing that annoys them the most is inconsistency and lack of instruction from the dentist. “Why don’t they just tell us how they like it? They only complain when it’s not done right.” Every single person in the office wants their dentist to succeed. In order for them to help you, you just need to give them more information.

Can you think of another important aspect of a practice? Team appreciation, bonus structures and outsourcing are other key elements. Join our New Dentist Business Club meetings where we go into detail in all of those. To join, email us at New.Dentist.Business@gmail.com.

Dr. Sampada Deshpande is a general dentist based in San Francisco. A foreign trained dentist from India, Sampada earned her DDS from the University of Washington in 2018 and is a 2020-2021 UW-LEND fellow. Outside of clinical dentistry, she enjoys teaching at the New Dentist Business Club and improving access to technology in healthcare via her involvement in Samsotech. You can reach her directly at @dr.deshpande on Instagram or visit her website www.sampadadeshpandedds.com for more information.

Editor’s note: We know that finding the right practice can be overwhelming and time consuming. That’s why the ADA created ADA Practice Transitions (ADAPT), a service that matches you with practices that fit your practice approach and lifestyle. We provide customized resources to ensure you feel confident in your decisions and an ADA Advisor supports you during each step of the journey. Learn more at ADAPracticeTransitions.com.

During his 20-year general dentistry career, Ryan Henrichsen, DDS, MAGD, saw hundreds of patients who were suffering from issues that had more to do with the structure of their mouths and throats than dental problems. “I was doing a lot of bite splints and guards because the dentists I was practicing with didn’t know how to manage bruxism and temporomandibular joint disorders [TMD],” he recalls. “I really started helping people by just doing what I was taught by the masters I learned from.”

As a partner at Gentling Dental Care in Rochester, Minn., Henrichsen found himself building many mandibular advancement devices, treating TMD and focusing more on the airway component of these conditions. When dental professionals began to take advantage of computed tomography (CT) scanning technologies to assess patients’ airways, “I knew that things were changing big time,” he says.

After mulling over the idea of opening a stand-alone office that focused exclusively on airway, snoring and TMJ issues for about seven years, Henrichsen opened Respira – Airway, Snoring, & TMJ in January 2021.

Cutting-edge treatment modalities

Before joining Henrichsen in the practice, associate Matt Merfeld, DDS, saw so many crowded and misplaced teeth that he decided to complete a two-year course in orthodontics. When he started working with Henrichsen, he took additional airway training. Merfeld became a Breathe Institute Ambassador and began treating tethered oral tissues (TOT), which contribute to upper airway resistance. He and Henrichsen then took hands-on training for Convergent Dental’s Solea Sleep CO2 laser so they can treat upper airway resistance and obstructive sleep apnea.

Merfeld says that one in ten infants and children are affected by TOT. If the condition isn’t addressed, adults compensate or “maladapt.” “We’re seeing a lot of neck pain and shoulder pain,” Merfeld says. “And just general tension. Those with the condition use the floor of their mouth and their neck muscles to compensate so they can breathe normally. There is this deep connective tissue attaching to the tongue muscles; it’s not just this little frenum that you can see visually.”

The condition can lead to other associated tongue position issues. “For instance, in adults, if the back of the tongue can’t go up to the roof of the mouth, we’re going to see breathing problems,” Merfeld adds. “What’s the airway component of the tongue? It’s not just swallowing and speaking, it’s breathing.”

“We use Solea for soft- and hard-tissue procedures,” Merfeld says. “For surgeries, we use the soft-tissue function, which has a wavelength that vaporizes the tissue. It coagulates the blood cells, but it’s not burning or cauterizing them, so we see much gentler healing.”

We use Solea for soft- and hard-tissue procedures. For surgeries, we use the soft-tissue function, which has a wavelength that vaporizes the tissue. It coagulates the blood cells, but it’s not burning or cauterizing them, so we see much gentler healing.

– MATT MERFELD, DDS

Unlike other lasers, Solea is noncontact. “When you’re applying the beam, the tissue looks like it just starts to disappear,” Merfeld says. “We can do surgeries in infants in about 10 to 15 seconds with minimal to no bleeding. Healing happens rapidly, so within two weeks, the tissues look like we did nothing. It’s very interesting technology. And the benefit for a general dentist is using it for other functions: cutting hard tissues, extracting impacted molars, and prepping teeth. It’s very precise and can focus the beam down to the width of a human hair.”

“The same laser has an attachment we can use as a snoring treatment component,” Henrichsen adds. “It requires no anesthetic and takes 10 minutes or less. We just zap the soft palate tissue and the uvula area, and it shrinks the tissue. The treatment alleviates snoring for about a year to a year and a half.”

According to Johns Hopkins Medicine, about 45% of adults snore sometimes and 25% snore regularly. Of the population of people who snore, Henrichsen says that roughly two-thirds have sleep apnea. “So one-third we could treat with the Solea Sleep application,” he explains. “It’s pretty amazing and we’ve had some good results with it.”

Merfeld adds that a benefit of the Solea laser is that it doesn’t have as many settings as other lasers. “It’s operated more like a general handpiece. It has a traditional rheostat, and we control the energy of the beam as we’re cutting. You start off at very low power and bring it up to the energy level you need. Solea is very user-friendly and versatile.”

Switching to the Solea Sleep function requires only changing out a small handpiece. The software identifies what they’re using, what function they need and what the light pattern should be.

Henrichsen offers several devices to treat snoring. The Vivos (or the DNA appliance) is custom designed for patients by a proprietary diagnostic algorithm after measuring and analyzing the oral cavity and airway with cone beam computed tomography.

The practice’s protocol also includes having a myofunctional therapist work with patients, focusing on muscle therapy, tongue position, range of motion and other elements both before and after surgery.

Since the practice opened in January, Minneapolis-area dentists have started referring patients and going to the clinic themselves.

A great deal has been written about patient-centered dental care. Jill Malson, key accounts manager with Patterson Dental, describes it as “the conversations, the conveniences, huddles and decisions the practice makes about equipment purchases, new procedures, protocols and policies … everything that goes into running the business has a true focus on benefiting the patient.” 

The patient schedule is a focal point when creating and managing a patient-centered practice because it allows you to streamline workflow for the benefit of the patient and the practice. If you want to create a strong, productive patient base that understands the urgency and value of their appointment, consider these nine tips when creating your patient-centered schedule.

1. Appoint a dedicated scheduling coordinator

“I can’t express enough how important this position is,” Malson says. When several staff members are scheduling patients, accountability can be lost. With one person overseeing the daily and weekly schedule and then collaborating with the rest of the team, the practice can manage patients more efficiently. The scheduling coordinator will have a bird’s-eye view of the process and can work with the rest of the team to fill openings or understand why a patient wasn’t rescheduled.

In addition, the practice should make it easy for patients to make and confirm their dental appointments. Confirmation phone calls can be difficult for patients to take during the day. Instead, use a text message or email confirmation system that makes it easier for patients to follow through on the confirmation, thus making your patient schedule more reliable. Phone calls should be used when no response is received from the text or email. A dedicated scheduling coordinator will help ensure all the necessary steps are in place to support a solid patient schedule.

2. Use your insurance coordinator wisely

Insurance coordinators manage insurance verification, pretreatment estimates and insurance submission for the practice. Patients who haven’t scheduled larger treatment plans could be waiting to see how insurance is going to cover their procedure. They receive the same pretreatment estimate the practice receives, but they often don’t understand how to read it. Reaching out to help the patient understand the information and to get them scheduled for treatment reminds them that they’re important to the practice and helps them maintain their oral health.

Insurance verification is another area of opportunity. A verification is completed for every patient being seen in the practice and can be a solid way to identify other treatment opportunities for patients on the schedule. Malson uses fluoride treatment for adults as an example: “Most adults have recession, and a professional fluoride treatment provides protection to those exposed areas. Many patients assume it’s not a covered procedure by insurance, thereby passing on this elective fluoride treatment. The insurance coordinator who’s also focused on the patient will identify when treatment is covered and communicate that to the hygienist and patient. It’s a win-win for all involved.”

3. Fill last-minute cancellations effectively

Last-minute cancellations happen in every practice and turning them into a filled chair requires a certain amount of finesse. Don’t be afraid to call your scheduled patients to see if they can come in early. Your message is very important here. Train your team to deliver a patient-centered message so the patient will feel important and top of mind with the doctor, which builds trust and longevity. Malson offers two versions of a call to a patient:

• “Hi, Mrs. Smith. Dr. John has an opening in the schedule today and we want to see if you can come in and get your fillings completed on the lower right side before your cleaning today. Does 2:00 work for you?”
• “Hi, Mrs. Smith. Dr. John was reviewing your chart today and he asked that I reach out to you. Before your cleaning today, he’s able to take care of your fillings on the lower right side so they don’t get any bigger or cause more costly and painful problems. Does it work for you to come in at 2:00 today and see him before your cleaning?”

The first message sounds like you’re filling a hole in the schedule, whereas the second message sounds much more focused on the patient’s oral health.

Malson also recommends looking out into the week to fill a cancellation today. “If you had a 10:00 appointment cancel and it’s currently 8:00, use your schedule as a resource,” Malson explains. “Call the patient scheduled for 10:00 the next day who you know has a flexible schedule to see if they have time to come in today.” The practice is doing the work of filling the open appointments, but the process is patient-led. “Go through the patient charts and look for opportunity gems,” Malson says. “Is anyone behind on their cleaning? Can they come in a little earlier or stay a bit later after their restorative treatment?” Some team members may be hesitant to make calls to reschedule patients, but if you’ve fostered a patient-centered practice using these tools, patients will view the call in a positive light.

4. Be open to same-day dentistry

This is a true game changer for patient satisfaction and productivity. Patients appreciate the offer of convenience. “If a patient presents to you with an issue and you have time in your schedule to perform treatment that day, offer it,” Malson says. Patients have already taken time out of their day to visit your practice and will value the opportunity for same-day dentistry. In the end, they will tell their family and friends about their positive experience and there is nothing more valuable than the referral of a friend or family member.

Reaching out to patients who have not scheduled treatment emphasizes the practice’s concern for their health.

5. Follow up on outstanding treatment

Every practice has a list of patients who haven’t scheduled treatment that was discussed at a prior visit. Patients get busy and often forget to schedule their procedure, especially when the tooth is asymptomatic. The treatment coordinator in the practice should have a structured follow-up system in place to engage patients and ensure they get scheduled. We know decay doesn’t go away on its own and what might require only an occlusal filling now, might involve more costly and extensive treatment in six months. Reaching out to patients who haven’t scheduled treatment – and explaining the importance of making that next appointment – emphasizes the practice’s concern for their health.

6. Use your short call list

Most practices have a list of patients who’ve told the front desk team that they’d like to be called if an earlier appointment becomes available. But how often do practices actually use the list? When patients have expressly asked to be called but aren’t, they may wonder if you truly use the list. Malson says the list has many names based on your practice management software and recommends using it as a resource for filling canceled appointments. Patients will appreciate that you paid attention to their request and reached out.

7. Pay attention to your new patient retention rate

Malson emphasizes that practices should be attentive to the retention rate of all patients, but that new patients are especially critical because they haven’t yet built a relationship with the care team that leads to loyalty. Patients who’ve been with the practice for several years have already experienced your care and expertise. New patients who’ve seen you only once or twice will need time to achieve the same level of trust and loyalty, so pay close attention to them.

8. Understand the impact of appointment time

Every practice manager should spend some time walking through the office and listening to what’s happening in the operatories and consultation rooms. Are doctors and clinical staff making the best use of patient time? Can another clinical team member cover some of what the doctor is covering, so the doctor is freed up to see additional patients? Ask questions, spark conversation and talk about the movement within the schedule to ensure your schedule flows efficiently and productively.

Properly managing appointment lengths is a bit of a balancing act. With each patient appointment, you want to allow enough time to ensure the patient doesn’t feel rushed, yet not too much time that could potentially be wasted instead of scheduled for another patient. The smallest tweaks can make a difference. Even a five-minute time savings across five or six patients can provide opportunity for another procedure to be completed. More appointment availability for patients, more production for the practice. Malson, who has previously managed general dental, periodontal and oral surgery groups, has helped practices streamline their patient appointments to increase productivity and the number of patients seen each day while also ensuring each patient still received quality time and care.

9. Introduce new procedures and invest in technology

Patients trust you and your practice. Providing additional treatment options via new pieces of technology and procedures opens the door for patients to acquire more of their needed treatment in your practice. Not making those investments may mean patients are referred out for services they require. When Malson worked in oral surgery, she brought in same-day implant placement, digital impressions and All-on-4 procedures for patients in need of more extensive implant-retained treatment. This meant patients benefited from fewer visits and additional treatment opportunities in the practice they’d grown to trust.

– – –

This article originally appeared in Advantage by Patterson Dental.

• T-Bone
• September 27, 2020

For the past 5 years I have sworn off removable services in my office unless they involved dental implants.  About 2 years ago I took that a step further and swore off implant retained overdentures as well.

The truth is that we weren’t doing removable often enough to develop good systems to make it profitable.  Furthermore, the headaches of multiple appointments, adjustments, patient expectations, etc made it not enjoyable.

I have been down this road with many procedures in my career – where I decide I don’t want to do them anymore.  Each time technological advancements come around that transform the ease and predictability of said procedure.

Dentures Have Gone Digital (at the lab)

Unless you have been hiding under a rock, you have read numerous articles and case studies of how dentures have gone digital.

I first read about digital dentures from Avadent in the early 2010s.  At that time it was the laboratory design that was digital.  Honestly, I didn’t give it much thought because it required proprietary steps and seemed like more work on the dentist side of things.

More recently we have seen Dentsply Sirona (and many others) provide the ability to milland print dentures.  We even show you how to print denture bases and teeth in our 3D printing course in your office.

Truthfully, this advancement alone doesn’t excite me.  It doesn’t solve the in practice challenges of dentures – reducing visits, reducing lab adjustments, and less chairtime.

Dentures Go Digital (in the dental practice)

Sooooo..  what makes me even consider adding dentures back to our services list?  The fact, that it’s now reasonable to take digitize the clinical side of denture fabrication.  With advancements in intra-oral scanners and digital smile design – it’s now easier and more predictable and less visits with much better dentist-lab communication.

Case Example

A patient with existing dentures comes back to our office for new dentures.  She has an upper complete and a 2 implant lower overdenture.  In this past this would necessitate either duplicating the existing dentures (a complete pain), starting from new tissue level impressions, or using existing as trays and having lab return them same day and have the patient go without her teeth (both of which are hard to coordinate).

Instead we are able to take a double sided digital impression of the upper and lower denture while in occlusion.  This begins the transfer and communication to the laboratory.

Next I am able to utilize Smile Design (done using Powerpoint in this case) to outline the aesthetic changes we would like to make.

Here the lab can take this information and transfer it to the denture design software.  In this case 3Shape Dental Studio was used.  The overlay is used to ‘set’ the denture teeth at the new position to allow more tooth to show at rest and at smile.

The final denture design was completed in the software.  The lower teeth were intruded to not create excessive overbite.

From this design the laboratory is able to print try in dentures to test fit, bite, and tooth aesthetics.  I chose not to have any pink added, but this is an option if you like.

I’d like to remind you this will be the patients second visit!

The printed try in dentures are quickly and easily relined with wash impression material for fabrication of the final prosthetic.

While this isn’t ‘completely digital’ it is significantly more predictable and easier than the traditional denture method.  Moreover, much of this process can be delegated to a team member!

This is literally my first denture case I have done in nearly 3 years.  I never thought I would even consider it again.  I’ve got a few more coming up where I am going to push my limits (increasing vertical and more significant tooth position changes) with minimal visits.

The Sales Pitch

I’ve already mentioned our 3D Printing Course earlier if you are looking to add printing to your practice.

If you are ready to do more complex cases more predictably within the confines of a busy general practice, then I encourage you to look into our Business programs here at 3D Dentists.

B1 – Foundational Case Acceptance.  In this 1 day program we teach you and your team our 4 step framework for increasing case acceptance.  It’s the exact way we do it in my own dental practice.

B2 – Case Planning & Sequencing.  This is a new 2 day hands-on workshop, we teach dentists how to properly case plan advanced and emotional dental cases.  We utilize virtual implant planning, smile design software, and step by step case planning & sequencing worksheets to keep cases organized.  The end result is an increase in case acceptance by patients and better organization for team members.

We look forward to seeing you at our programs so we can help grow your dental practice!