“You are kidding, RIGHT??? Now I Have To Add WHAT Into The Hygiene Visit?”
Do you ever cringe when the dentist/owner announces she is going to an educational workshop to learn a new technique or procedure? Let’s be honest: you may get anxious not because you are against professional development or an enhanced service mix, but because you think, “Now what else am I going to be told to cram into a hygiene appointment?”
Meet Dr. Newsmile!
Dr. Newsmile has a thriving practice in a suburban setting, seventeen minutes outside a major city. She has been in practice for ten years and has an active patient base (anyone seen for any service over the last 18 month) of close to 2000. Part of Dr. Newsmile’s overall vision is to strive continuously to improve and innovate by offering state of the art solutions that exceed her patient’s expectation. To support her vision, she attended a 2-day seminar on the Six Month Smiles System as a new service offering for her new and existing patients.
Dr. Newsmiles knows the majority of her patient population is late teens and adults. She has been asking her patients and is aware that many of them have expressed the desire to learn about a solution for crooked teeth, crowded teeth, close anterior gaps and/or a conservative alternatives to veneers, restorative smile re-designs, and traditional braces.
She schedules a team meeting and announces within the next 3 months, her goal is to have the Six Month Smiles system fully integrated into the practice. Dr. Newsmile clarifies the return on investment she is looking for is not just an increase in productivity and profitability, yet she is very interested in attracting a new target profile patient who will be inspired to come to the practice for both cosmetic wants and also become an enthusiastic, general dental patient. The team sets a goal of starting 25 new cases, $100,000 in increased productivity, by the end of the year as a statistical interpretation of initial success. For the remainder of this team meeting, Dr. Newsmiles and team agree to “roll up their sleeves” and begin looking at which office systems would be impacted by introducing Six Month Smiles into the practice. The systems affected include scheduling, insurance, financial arrangement, clinical assessments, treatment presentation, marketing, continuing care and of course the actual delivery of the short-term ortho system.
This article will provide the reader with 4 key hygiene implementation steps dental teams can use to integrate short term ortho services successfully into their practice.
Step #1: Don’t Step Over Dollars to Pick up Prophy Pennies
Time studies show the length of time to complete all of the services involved in a prophylaxis appointment as being between 53-67 minutes. Many offices unwisely schedule (and sometimes double-book) hygiene patients. Many schedule adult prophylaxes, in 20-, 30- or 40-minute appointments and then complain that the doctor’s schedule is not full, or they have a lot of no-shows and cancellations and in Dr. Newsmile’s case, fear that her Six Month Smile goals will not be achieved. This is akin to stepping over profitability dollars to pick up "prophy" pennies.
Dr. Newsmile knows her hygienists need the appropriate amount of time to ensure their patient receive a quality experience which may now include taking additional photos and asking open-ended questions such as, “On a scale of 1-10, how would you rate your smile?” or “Tell me what you think about the gaps/large spaces between your front teeth?” To support the new goal, she changed the hygiene time increments from the a15-minute schedule to a 10-minute schedule and increased prophy appointment time to 60 minutes per adult patient.
Step #2: Marketing
Dr. Newsmile and team must create a strategy and calendar to generate awareness, engagement and commitment regarding Six Month Smiles for new and existing patients. They look at internal marketing strategies including education and new scripting during the hygiene appointment, e-newsletter, articles, brochures and testimonials in the reception area and posting on-line. An example of a new service education script is the following:
"Our practice now offers Six Month Smiles. The Six Month Smiles system allows us to create beautiful smiles for the patient who does not want to take the time traditional braces might take. We can complete your treatment in a short amount of time, which means fewer office visits which mean less time from work or classes.”
Step #3: Training
During data collection and carrying out clinical assessments, the hygienist sets the tone for education, partnership, and purposeful conversations focused on learning the patients’ motivators, concerns, needs and/ or desires that influence treatment acceptance. Dr. Newsmile already knows her hygienists’ perform through assessments of patients (medical and dental history, vital signs, head and neck screenings, periodontal) She also knows they educate patients about the links between gum disease and systemic illness. Moreover, now, she is developing a training plan and protocol to further their knowledge about:
- Association between untreated occlusal discrepancies and the progression of Periodontal disease
- Occlusal treatment reduces the progression of Periodontal disease over time and is an important adjunct to comprehensive periodontal therapy
For example, if during the periodontal assessment the diagnosis is root planning and crowding was noted, then a case presentation conversation would include a discussion of the association between untreated occlusal discrepancies and the progression of periodontal disease. Or if there was a heavy amount of mandibular anterior, say “I’m documenting the heavy amount of calculus on your lower front teeth, and because you stated that it’s very hard flossing and keeping them clean, I’m curious if you know about the conservative treatment we specialize in that could straighten those teeth in about 6 months?”
Step 4: Exam in the Body of Appointment
Dr. Newsmile acknowledges she often keeps the hygiene patient waiting and often the periodic exam is rushed. For her and her team to meet their new short term ortho service goal, they decide to change when the periodic exam takes place during the hygiene appointment. So, for new and existing patients, she will no longer wait until the end of the appointment to perform the exam. Once her hygienist has collected all the clinincal data, patient’s motivators and concerns, and restorative needs, she will be alerted to come in and complete the examination. Leaving valuable treatment conversations, especially with patients who share your enthusiasm about cosmetic options and new technologies, may decrease your acceptance rate. Why? Because the human mind needs time to process and come to a decision. A confused or rushed mind will more often result in some version of “no.” Dr Newsmiles is dedicated to “planting the seeds” during the “body” of the hygiene visit to allow her patients’ time to get excited about the possibilities of a more beautiful smile. Plus, allow appropriate time for her hygienists to debrief the patient and answer any questions that may prevent them from moving forward with treatment.
The doctor-hygienist exam must be orchestrated with the goal of supporting the patient to say YES to the care they need and or want. Steps for the doctor exam may be: greet the dentist; summarize the appointment up to that point; focus on any conversations about needed or wanted restorative treatment or smile enhancement; and include any patient concerns or resistance in the handoff to the dentist. For example, “Hello, Dr. NewSmile, Mr. Franco and I were just talking about his interest in straightening his front teeth. I took intra-oral pictures earlier, and I believe he would be a good candidate for Six Month Smiles. Mr. Franco would like to begin treatment when you verify that this fits with his treatment plan. We were also talking about whitening his teeth, so I took a shade, too. I believe he could get to X shade.”
With careful implementation, Dr. Newsmiles and team get to provide their patients a solution that aligns with their vision and is truly a life changer-a beautiful smile in a minimum amount of time that will improve a patient’s life socially, psychologically and financially!. Successful dentists and hygienists know properly utilized and scheduled time for and during a hygiene visit is decreases stress and increase profitiabitliy and productivity. Don’t fear new services, profit from them!
Kristine A. Hodsdon RDH, MSEC, a.k.a. Dental Feminista, is the founder of Dental Influencers, LLC an international executive coaching & consulting company. Her specialty is corporate consultant services and leadership and sales coaching. She held the position of Editorial Director of PennWell Publishing’s RDH eVillage e-newsletter from 2004-2016, helping grow it to over 60,000 subscribers. Before starting Dental Influencers, she was a director of dental services managing a $3M operational budget with a team of 30 dental providers and had been a sales consultant and educational manager for a global fortune 500 company delivering presentations and trainings for national and international audiences. As an award winning speaker, she invites you to connect with her regarding consulting or speaking at www.kristineahodsdon.com