We all know how busy the dentist and staff are in a successful practice.  As a matter of course, those practices work with successful and reputable dental laboratories.  The trend follows because of the need for expert technical assistance from the most experienced dental technician/technologist in the laboratory.  The dental technologist is in the position to serve the practice and as such makes him or herself immediately interruptible and available to the dentist and staff any time they call or visit the lab.  This is a great position to be in as a highly valued member of the dentist’s team.

This brings me to the meat of the subject – communication.

Too often a dental technologist will call or email the dentist or staff to ask for items that were not included on the work order and, too often the dentist and staff are too busy with a patient in the chair to respond.

Keep in mind that the dental technologist is acting for a patient who is expecting their new smile to be delivered on time, yet the response to the dental technologist may be given low priority.  The call back comes too late or is completely ignored leaving it up to the dental technologist to continually follow-up by phone or email.

Keep in mind that the dental technologist is acting for a patient who is expecting their new smile to be delivered on time, yet the response to the dental technologist may be given low priority.  The call back comes too late or is completely ignored leaving it up to the dental technologist to continually follow-up by phone or email.

In my lab of 75 core dentist clients this is the rule rather than the exception.  I think the solution is to view the dental technologist more as an advocate for the most important patients in the practice and not as an interrupter who can be ignored.

Some time ago I wrote a pictorial article explaining my suggestion that all dentists should, at some time in their career, pour casts from their impressions and trim their own master dies.  In my experience, all dentists who have followed this practice have improved their impression techniques immensely.  Following that practice all dentists begin to look at their own impressions much more critically and their impressions improve as a matter of course. The resulting restorations fit far better and the dentist’s appreciation for their own personal skill raises to one of fulfillment.

At the end of the day, both the dentist, dental staff and dental technologist want to provide the best experience and restoration for the patient.  Clear and timely communication and great impressions will help go a long way in ensuring a positive outcome.

Steve Killian studied dental technology at Southern California College of Medical and Dental Careers, graduating in 1973, number one in his class. Soon after he joined with Jim Glidewell Laboratories and became senior ceramist and general manager for two of his laboratories, El Toro Dental Ceramics and later Cal-West Dental Ceramics. In 1980 Stephen became a National Board Certified Dental Technician in Ceramics. With his growing interest and attention to premium esthetics and quality, he opened his own laboratory in 1983. Steve began to partner

with his brother Greg in 1985 allowing Steve to focus on the technical side while Greg focus’ on the administrative side of Killian Dental Ceramics, Inc, CDL a 30-person lab in Irvine. Steve has served on NADL in various capacities since 2011 and now serves on the board for The Foundation for Dental Laboratory Technology, promoting education and awareness in the profession, while raising money for scholarships, grants and on-line learning programs.

Notable Positions

• The National Association of Dental Laboratories, The Foundation for Dental Laboratory Technology – January 2017 Fundraising Committee Chair, three-year term
• The National Association of Dental Laboratories, The Foundation for Dental Laboratory Technology – August 2013 Elected to Board of Trustees, three-year term
• The National Association of Dental Laboratories, Board of Directors – January 2012 Dental Laboratory Representative at Large, two-year term
• The National Association of Dental Laboratories, Board of Directors – January 2010 Dental Laboratory Representative at Large, two-year term

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LMT asked dentist-participants in our 2018 Dentist Survey to rank the challenges they assume laboratory owners face. Interestingly, they were correct in choosing the top two, saying a lab’s biggest struggles are hiring competent staff (which lab owners ranked as their #2 problem) and making do with inadequate work by clients (which labs ranked as their #1 challenge.)

With regard to the challenge of hiring qualified technicians, some dentists expressed concern about the future of our community, citing declining educational programs and the aging technician base. “Let’s concentrate on actually supporting the dental technology industry with training programs, rather than pushing everything onto a computer,” says a dentist from Florida. “There is so much we cannot do digitally and we will need to have people who still understand this.”

Some dentists also commented on the difficulty laboratories have in dealing with subpar work from their clients, urging laboratories to hold them accountable.

“Feedback is crucial; don’t be afraid to tell us you need a better impression or more information. Any dentist who is too proud to receive feedback is not serving his/her patients and will not improve clinically,” says a dentist-participant from Tennessee. “Don’t be afraid to hold your dentists to the same standards as they hold you.”

Labs Weigh in

Similarly, laboratory-respondents to LMT’s 2018 Relationship Survey were asked: what do you think are dentists’ biggest challenges when running their practices? They were right on the money, not only choosing the same two problems the dentists did—dealing with insurance companies and hiring competent staff—but also in the correct order.

It’s possible laboratories were so easily able to identify a dentist’s number-one struggle because it has an effect on them. “Insurance reimbursement is the biggest issue; we have great clients who are constantly battling this problem,” says Kelly Pickworth, CDT, Owner, Ohio Dental Lab, Mason, OH. “The impact of this on our lab is huge: they are constantly requesting lower fees to deal with reimbursement problems.”

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When was the last time you felt stressed because things didn’t go according to plan and you felt like you lost control? Was it last week? Yesterday? Today, right after lunch? Or 20 minutes ago?

Stress is part of our daily lives. We wake up early and try to do 10 things before leaving the house. If you have kids, maybe 15!

If you’re lucky enough to live in beautiful Southern California, add at least another 30 minutes to your morning and evening commute.

Even if you show up to work in an almost perfect state, other factors may ruin your day: the patient is late, the lab messed up the shade, your new assistant sets up the wrong bur while you have the most demanding patient in the chair, and Mrs. Smith is back again for the fourth adjustment on her denture reline, ignoring the fact that you recommended a new one.

Should I go on?

As a practicing dentist for more than 25 years, running multiple multi-specialty group practices, being the self-proclaimed “best mom in the world” to three beautiful children, and trained as a Certified High Performance Coach, I have been blessed to learn and discover strategies to live my life with intention and conquer the stress that plague many dental practitioners.

I still have stress, of course. But most of the time I see it as the “good stress,” the kind that challenges and pushes me to do things better, to finish faster, and to beat my own last record!

So the next time you feel stressed and you’re facing a difficult situation, dealing with the unknown, and about to pull your hair out, take a moment to reflect, reframe, and practice five high-performance habits: clarity, energy, productivity, courage, and influence.

Clarity

Clarity is knowing who you are, what you want, and what is most important to you. A lot of time we feel stress because we are wearing too many hats: owner, operating doctor, “boss,” CEO, parent, child, friend, advisor, and so on and trying to please too many people.

Ask yourself when the last time was you put yourself first, because it is important to take care of yourself first so you can serve other people. When you become real clear in your vision and goals, then you should only do the things that support those goals. The rest can wait! When you clearly recognize what’s most important, it becomes a lot easier to prioritize and commit.

Energy

When you don’t have enough energy to get through the day, things become stressful very quickly. You’re tired and not concentrating. You rely on coffee and sweets to combat the afternoon crash. (The next time you’re in a seminar, just look at the people who have soda, coffee, and candy in front of them!) Many professionals don’t get enough sleep. If you think about it, most of us have an 8-to-5 or 9-to 6-job. If you take work home, it is entirely your choice. If you stay up late, it is also your choice.

If you don’t have time to exercise (whether it’s a stretching routine in the morning, a walk at lunchtime, or something else) or close your eyes and rest for 5 to 10 minutes during the day, it is because you don’t schedule it, block the calendar, and allow yourself that “me” time. It may sound childish, but this is the exact same thing I have to remind my clients to do to maintain their energy all the time.

Productivity

Productivity should be measured by results, not by being busy. Some people live by checklist, and if things aren’t checked off, they get stressed. Some people go through the motions because it’s just another day. Being productive requires you to be very intentional.

If you want more referrals, train your staff to ask for them and also ask for them yourself. If you want to streamline your business, implement systems and possibly hire a coach or consultant for help.

Try this exercise. List everything you do in a working day, such as answering email, checking your phone messages, chatting with your staff, performing chairside work, and taking clinical notes. Put a checkmark next to the activities that produce income and delegate the tasks that don’t produce income.

You may find the few things that should be on your list are chairside work and preparing marketing strategies. The rest you can delegate. Even with clinical work, you can have an associate or specialist replace you!

Courage

No one wants to be uncomfortable, yet it is essential to growth. Doing something out of your comfort zone requires courage and commitment. Remember your first major purchase, like a house, a practice, or a piece of high-tech equipment? How about a tough conversation you need to have with your spouse, your staff, or a difficult patient?

We get stressed out because we avoid the “conflict” that helps us grow. The sooner we decide to follow through with our big decision, maybe with a coach or an advisor, or to let go and have no regrets, the sooner we will feel less stressed in dealing with these situations.

Influence  

We get stressed when we cannot manage our team. We feel challenged when patients don’t follow our treatment recommendations. Positioning yourself as an expert and learning principles of persuasion will help you become more confident. If you are clear in your vision and goal, you can be pushy and get people to follow you, engage with you, and do what you asked them to do.

Your Turn

These habits should be your way of life. Get real clear in your vision, goals, and values, and start being very intentional about your daily schedule, what you spend time on, or the people you need to please.

When you face a tough decision and feel overwhelmed by stress, evaluate it via these habits, handle the bite-size challenges, and don’t let the stress control you. Believe in your ability to figure things out, as you have all along, and reach out for help if you need to. If you lead your life with controlled stress and well-defined intentions, you will find yourself happier and more productive.

Dr. Letran is an international speaker, author, and Trainer in High Performance Leadership. She also has been the CEO of several multi-specialty dental group practices for more than 20 years in Southern California. She is a former president of the UCLA Dental School Alumni Association. Also, she is the local club president of CEO Space, and Certified Marketing Advisor of the No BS Inner Circle. She is the founder of the Emily Letran Foundation, which provides basic dental care to disadvantaged veterans and families during her monthly Free Dentistry Day, as well. She can be reached at coachemilyletran@gmail.com. For a consultation, visit exceptionalleverage.com/form or exceptionalleverage.com/businessreport.

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If you’ve had issues with your teeth that involve weakening, white spots, or numerous cavities, one of the key causes could be demineralized enamel. To understand what demineralization is and how to remineralize in order to address the problem, take a look at this guide. You’ll understand that demineralization is not actually damage to tooth enamel – but it is the first sign that such damage may be coming soon, among other problems. Fortunately, demineralization can be stopped, and your teeth can remain protected.

What Is Demineralization?

Just as it sounds, demineralization occurs when the mineral content decreases in your tooth enamel. It is the first step to tooth decay and can be caused by several things that dentists recommend avoiding or moderating. Enamel is such a hard and protective substance for your teeth precisely because of its high mineral content, and generally speaking, demineralization has to happen before cavities and other problems occur. Once plaque pierces enamel weakened by demineralization, it more easily infects a tooth’s vulnerable interior, made of dentin and the tooth’s sensitive root. By avoiding demineralization, you can drastically reduce the chance of this happening.

Demineralization also contributes to making the teeth less attractive and oral hygiene more difficult, and it often leads to brushing being painful or less efficient. One key feature of tooth enamel is its smooth, slippery surface, which also fades away with demineralization. As the teeth get rougher, their surface area increases and plaque, tartar, and staining elements coat the teeth more readily.

How to Avoid Demineralization

For the average person in developed countries, overly acidic or sugary drinks such as sodas are the chief cause of demineralization. Brushing too hard, not keeping up with proper oral hygiene habits, and other issues with oral care will also contribute. An overly acidic oral cavity is a common cause to watch for, especially in places like the North America where the average diet is acidic. Sometimes other dietary issues can also cause demineralization, though this is less of a concern in Western societies (more on this later).

The unfortunate truth is that enamel cannot be restored or regenerated. This is because enamel is not a growing organic tissue like skin or bone, and there are no other sources of enamel in the human body that could be used for grafting. However, fluoride, an inorganic chemical compound common in dentistry, is the chief solution, used for a reversal process called remineralization.

Fluoride Treatments

Fluoride is a naturally occurring mineral, and as one might expect, it is very useful to restore the mineral qualities of tooth enamel, remineralizing teeth back to being smooth and strong. The most common way dentists use fluoride is by applying a foaming gel to the teeth after thoroughly cleaning them. You can also purchase such gels for you to use at home or toothpaste with a special extra-fluoride formula.

Fluoride has been so helpful for oral health and maintenance that some cities add small amounts to drinking water. It is generally safe in small quantities, and little is needed for dental fluoride remineralization gel treatments. That said, do not start using fluoride gels or an extra-fluoride toothpaste without consulting your dentist first. The additional minerals can be wasteful or even detrimental in some patients who were not facing demineralization after all, or who have a rare sensitivity to fluoride.

Dietary Issues

While more common outside of developed countries, sometimes demineralization can occur because too few minerals are being absorbed in the diet. It’s important to get the proper levels of calcium and phosphates, which come from dairy products and many types of green leafy vegetables. Fluoride can also be consumed naturally by drinking mineral water or certain types of tea, eating seafood or wheat, and a number of other things. If you want one simple solution, consider chewing sugarless gum. Saliva is the ideal self-protection for your tooth enamel, and the gum will encourage your mouth to produce more.

Take note that packing more of these food and drink items into your diet, thereby putting more minerals into your body, will not compensate for demineralization. The human body can only absorb the ideal amount of minerals every day or less, and forcing more into you will mostly have no effect, except in extreme cases where it can cause risky health issues such as kidney stones when combined with dehydration.

Demineralization might be good for things like water, but it’s never something that you want for your teeth. While demineralization isn’t damaging in itself, it is the weakening of the enamel that preludes damage such as cavities. Therefore, remineralizing your teeth through proper oral hygiene is crucial. Be sure to also watch your diet for things like soft drinks, and to visit the dentist at least once or twice a year to get a deep cleaning and proper treatment for your situation.

It can’t be stressed enough: Visit your dentist regularly and you’ll have a major head start against the progress of any demineralization.

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There is serious hidden epidemic that the public health community is just discovering. Its most obvious symptom is the growing frequency of children with crooked teeth wearing braces. But it also includes snoring, jaws hanging open, frequent stuffy noses, attention and behavioral problems, unrecognized disturbed sleeping (sleep apnea), and a general decline of physical appearance.

These symptoms indicate a building medical emergency that will likely catapult dentists, orthodontists, and sleep scientists into the front line of public health professionals. The emergency lies in the collection of serious diseases connected with mouth breathing and disturbed sleep, including heart disease, cancer, attention deficit hyperactivity disorder (ADHD), depression, schizophrenia, suicide, asthma, and perhaps Alzheimer’s disease.

Disturbed sleep is an extremely serious stressor of the human mind and body. Among other things, it tends to depress the immune system, making an individual much more vulnerable to a wide variety of diseases and resulting in myriad modifications to the brain that are only partially understood. Add to this the large contributions of sleep deprivation to highway accidents, medical mistakes, and poor performance at work and in school, and you can see how important this unrecognized public health emergency is.

The Dental Connection

The dental connection comes from poor jaw development, which can be traced back to environmental changes resulting from industrialization. One primary cause is a lifestyle that reduces the amount of chewing a developing child needs to do. Since industrialization, children are no longer weaned to the relatively tough foods their parents eat. Instead, they are switched to soupy baby foods.

Indeed, in their early lives, children often transition from pablum to a fast food diet that is becoming increasingly soft and liquid-like. Few kids get to gnaw on a tough buffalo haunch, instead feasting on hamburgers, cakes and candies that melt in their mouth, sugary soft drinks, and the like.

When mothers can nurse, many cannot do it for long enough, or they may pump their breast milk and have a caregiver deliver it through a bottle. They recognize this is excellent for the child’s nutrition, but nursing directly from the breast exercises the jaw muscles. Having milk poured into their mouths from a bottle, not so much.

This lack of exercise causes poor development of too small jaws, crowded and crooked teeth, impacted last molars (wisdom teeth), and unattractive long faces and receding jaws. To understand why hardly requires rocket science. Imagine how leg development would be affected if children were not allowed to walk.

Another environmental change that contributed to the epidemic was moving indoors, where things that cause allergies such as dust mites and formaldehyde concentrate. Allergies create stuffy noses, and that leads to mouth breathing. That, in turn, bypasses the natural air cleaning, warming, and humidifying functions for which the nose was designed.

Since the bottom of the nose is the top of the upper jaw, this changes the pressures of the air flowing through the nose and mouth, hindering jaw development. This phenomenon was documented long ago by experiments in which blocking the noses of rhesus monkeys produced great distortions in their jaws.

Potential Solutions

The “cures” for the jaw epidemic are simple in outline. First, we must return childrens’ diets to much chewier foods, perhaps even supplementing them with special tough chewing gums. We must also modify some current orthodontic techniques to emphasize forward movement of both jaws and avoid extractions.

Dentists should encourage “forwardontics,” a program focused on keeping the airway open, through sets of exercises designed to correct jaw “posture.” We have learned that how one’s jaws and tongue are held when not eating or talking is key to healthy jaw development.

At the public level, a determined and well-supported educational program will be necessary. At the personal level, healthy jaw development will require careful and long-term cooperation of children (and parents) who have not benefited from jaw-friendly rearing, all under the supervision of dentists familiar with forwardontics.

While new studies and books are making headlines about the rising epidemic of poor sleep, none have examined its startling relationship with poor jaw development until now. Jaws: The Story of a Hidden Epidemic uncovers this serious, mounting, but virtually unknown public health crisis.

Most people in industrial societies today do not recognize the facial distortion that is common, the spreading of sleep apnea, the extent of children wearing braces, or other symptoms of an epidemic in oral-facial health that can be traced to how most people eat and hold their mouths at rest.

People tend to accept the world in which they grew up as the standard. But what is common is not necessarily “normal” or healthy. There is growing evidence that a substantial portion of the population could have better lives when it comes to oral-facial health and the many consequences of its lack.

Indeed, if spreading knowledge about oral-facial health could become a civilization-wide priority, a huge dent could be made in the swelling epidemic of sleep apnea (and possibly a lesser dent in several other nasty diseases, ranging from heart problems and cancer to mental decline). Our hope is that many children and their families could avoid the medical consequences of poor oral posture and the high cost of correcting it entirely.

Dr. Kahn is a graduate of the University of Mexico and the University of the Pacific. She has 25 years of clinical experience in orthodontics and is part of craniofacial anomalies teams at the University of California, San Francisco and Stanford University. She can be reached at forwardontics.com.

Dr. Ehrlich has been a household name since the publication of his 1968 bestseller, The Population Bomb. He is Bing Professor of Population Studies Emeritus and president of the Center for Conservation Biology at Stanford University. He also is a member of the National Academy of Sciences and a recipient of the Crafoord Prize, the Blue Planet Prize, and numerous other international honors. He investigates a wide range of topics in population biology, ecology, evolution, human ecology, and environmental science. He can be reached at pre@stanford.edu.

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The thought of getting orthodontic treatment can be scary for patients, and if you feel like you’re meeting resistance when you suggest it, you’re not the only one. Many dentist find it difficult to get patients on board with the idea of dental braces, while other seem to have no trouble with patience compliance or engagement.

The key lies in the way you handle the conversation, and theses simple changes can help:

Courtesy Puts Patients at Ease – We tend to assume that patients are ready and willing to have a discussion about their dental care. This is probably true, otherwise they wouldn’t approach you for a checkup or orthodontic treatment at all!

However, try asking for permission before entering the conversation. Most patients will agree to the discussion, and this agreement creates a sense of responsibility and participation. It makes them more likely to pay attention to your questions, advice and suggestions, but also shows that you’re giving them a choice instead of just “preaching” at them.

Focus on a Two-Way Conversation – As health professionals, we’re used to jumping straight to the point, telling patients about any problems we notice and what they should do about it. Any successful discussion goes both ways, though.

It’s important to understand your patient’s needs, awareness and involvement as well. For instance, ask if they know why they need orthodontic treatment, or whether they are familiar with the different types of braces. Asking questions will also tell you if they’re more interested in cosmetic or health benefits, so you can customize your responses.

Point Out Positive Aspects Too – We’re often so focused on dealing with dental problems that we forget about mentioning areas where a patient has good dental health. These can act as a powerful motivational tool for people.

For instance, if someone has crooked but cavity-free teeth and healthy gums, take a moment to recognize the effort they put into dental hygiene and care. Then, you can bring up solutions for realigning their teeth. This builds patient confidence, making the end goal seem closer and the process far more manageable than talking only about problems.

Put Time and Investment into Perspective – Most people worry about the time and cost involved in orthodontic treatment. Overcoming these barriers becomes easier when you compare against the long-term benefits of braces.

For example, you could mention that just a year or two of wearing braces could prevent a lifetime of self-consciousness for a child with misaligned teeth. The same way, an investment in braces or aligners today could help both children and adults avoid severe dental problems down the line, which would be far more expensive, painful and time-consuming.

An Indirect Approach Could Help – Motivating patients to take care of their braces, or even agree to get them can be challenging. After all, telling them they need orthodontic treatment is not always enough to make them want it.

Instead, try introducing them to the benefits of certain types of braces indirectly. If they aren’t worried about how their teeth look, for instance, mention that metal or ceramic braces have helped other people bite or chew better. For those concerned about aesthetics, quote specific examples of patients wearing lingual braces without anyone noticing them.

With various types of braces available these days, there’s something to suit every patient’s needs. Asking the right questions and making patients feel like part of the conversation is the most effective way to increase their confidence in you, and motivate them to get orthodontic treatment at the earliest!

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Ask anyone how they feel about honesty and integrity, and they would agree that both are important attributes to have. Almost everyone would also claim that they possess both of these traits. However, in this new era of business and leadership, we are seeing honesty and integrity break down every day.

Simply scroll the latest online news feed or watch the evening news. America’s top companies, executives, and politicians are being investigated, indicted, and fines at unprecedented rates. It’s a stark reminder that honesty and integrity are still crucial to success, and it’s critical for dentists to uphold these values within their practices. Practice leaders are constantly being observed by their staff. If your staff takes notice of conduct that’s lacking in values, it can lead to undesirable  attitudes, actions, and behaviors.

Imagine an office where the dentist touts personal and professional growth, but when it comes to bringing in software trainers, decides it is way too expensive. Or picture a dentist who holds the team accountable for the highest levels of customer service, but constantly belittles patients or talks badly about them.

In my more than 30 years of working with dental practices, I’ve seen both of these types of leadership breakdowns. Both scenarios always result in a team that lacks trust and commitment to both the dentist and the practice. Want to create a culture of integrity and honesty that helps build a successful practice? Follow these three tips:

• Be transparent: Leaders have to be willing to reveal certain things about themselves. Part of that revelation is what they stand for. Dentists should go out of their way to share their purpose, mission, and values with the dental team. This doesn’t have to be a three-day retreat. They just have to be honest about what they stand for and how they want their patients to be treated.
• Do what you say you’re going to do: If you tell your team you want outstanding customer service, live it. If you’re committed to team development, invest in training.
• Be consistent: If a leader makes a claim one day, violates it the next, and restates it the third day, people begin to feel like the leader lacks integrity, and they lose trust.

By displaying traits of honesty and integrity, doing what you say you’re going to do, and talking to your team about your values on a regular basis, you can have a happy team and an amazing practice.

Dr. Levin is a third-generation general dentist and the chairman and CEO of Levin Group Inc, a leading dental management and marketing consulting firm. To learn more about the company’s training and consulting services, visit levingroup.com, or contact him at roger.levin@levingroup.com.

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The tooth fairy may have been on to something when he started collecting baby teeth from young children in exchange for loose change. Right now, stem cell researchers see great promise and value in teeth, especially baby teeth, chiefly for the abundant number and quality of the stem cells cached away in them.

Most of the body’s stem cells are difficult to extract, found in fewer numbers, buried deep in tissues adjacent to similar-looking surrounding cells. But stem cells found in teeth are numerous and readily extractible. What’s more, dental stem cells appear to be among the fastest replicating stem cells discovered to date.

Dental stem cells can be easily extracted and preserved for future medical treatments, but what’s really exciting dentistry is recent research that suggests they can be used to regrow teeth lost to decay. Pre-clinical findings suggest that the days of mercury-lade amalgam fillings may be numbered, replaced by a new mixture, containing stem cells, that will stimulate the dental pulp into producing its own replacement tissue.

Stem cell research on humans has not yet been approved in the United States, so the experimentation to date has been conducted on laboratory mice. That said, the findings from this research clearly indicate that stem cells found in molars, wisdom teeth, and baby teeth can be injected into a decaying tooth, resulting in the rapid growth of replacement tissue and blood vessels. Researchers have been able to regrow entire sets of teeth in these mice.

Synthetic biomaterials that have been separately developed by researchers at Harvard University, the University of Texas, and Britain’s University of Nottingham back these findings and have been shown to kickstart dental pulp regeneration in the surrounding dentin.

This is exciting news, as saving a patient’s natural tooth is always the preferred outcome. Implants and dentures come with their own potential problems and generally aren’t as strong or comfortable as the real thing. The new stem cell research suggests that decay caught early enough could be reversed, thus preserving a patient’s tooth and eradicating the need for procedures like root canals or reconstructive replacement. It’s also a huge step forward to be treating teeth with biomaterials rather than other synthetics, which may eventually break down and interact with the body’s chemistry.

Because it already has been greenlighted for other non-dental afflictions, the low-cost experimental drug Tideglusib shows particular promise for securing fast-tracked approval. The drug has been shown effective in stopping tooth decay. And with some 18 million dental procedures expected to be carried between 2017 and 2024, as the world’s senior population continues to grow, there’s a ready market available for these types of applications.

With millions of dental stem cells being handed over to the tooth fairy each year, it’s a shame human trials are still a ways off. But it is promising to see applications for stem cell research continue to progress, and perhaps one day soon dental regeneration will become the new norm.

Dr. Harwood is a graduate of the Tufts University School of Dental Medicine with an advanced degree in endodontics. He was the first endodontist in New York to use a surgical operating microscope. Also, he is a member of the ADA and a specialist member of the American Association of Endodontists. He has taught endodontics at the Tufts University School of Dental Medicine, New York University School of Dentistry, and the Metropolitan Hospital Center.

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The House of Representatives passed the Action for Dental Health Act of 2017 (HR 2422) by a vote of 387-13 on February 26. Co-authored by Congresswoman Robin Kelly (D-IL) and dentist and Congressman Mike Simpson(R-ID), it authorizes $18 million annually for Centers for Disease Control and Prevention (CDC) Oral Health Promotion and Disease Prevention Programs and $13.9 million annually for five years for Health Resources and Services Administration (HRSA) grants to states to support oral health workforce activities.

“Unfortunately, too many Americans lack access to oral healthcare because of cost or a lack of dentists in their area. This bill starts to change that by making oral healthcare more accessible,” said Kelly. “In a time of a deeply divided Congress, I’m glad that Congressman Simpson and I could put forward a bipartisan bill that would win the support of hundreds of our colleagues.”

“I am thrilled with the overwhelming bipartisan support for the Action for Dental Health Act,” Simpson said. “With house passage today, we are advancing a solution to better utilize resources to improve early diagnosis, intervention, and preventive treatments which can stop the progress of oral diseases.

The bill would establish a new “Action for Dental Health Program” within the CDC account that would provide grants for oral health education, dental disease prevention, and reducing barriers to dental services. Eligible entities would include state or local dental associations, state oral health programs, dental education programs, or community organizations that help facilitate dental services for underserved populations.

As part of the HRSA grants, the bill would expand programs that provide oral health services in dental health professional shortage areas to include:

• Establishing dental homes, which the American Academy of Pediatric Dentistry has defined as comprehensive oral healthcare, for children and adult
• Establishing initiatives to reduce the use of emergency departments for dental services
• Providing dental care to nursing home residents.

The bill has been received in the Senate, where it has been read twice and referred to the Committee on Health, Education, Labor, and Pensions. It has been endorsed by the ADA, the National Dental Association, the American Dental Education Association, and other organizations.

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There are influential moments when opportunities occur to discuss and validate your treatment options with patients. Finding occasions to introduce and sustain the perception of quality care is the responsibility of every team member.

From vital social media exposure to the initial moment of telephone contact and post-treatment continuing care visits, the team is building a quality culture during all patient encounters. Every team member is responsible for those critical moments when the patient’s choice to choose your practice and your care is validated.

Why is this important? Experts contend that more than 80% of the reason patients choose to work with your practice is based on the relationship that is developed between them and you. The relationship begins the moment the patient comes in contact with your practice, through your social media presence to the initial telephone encounter and entrance into your office and connection with your team. Further studies suggest that patients decide to choose your care within 10 minutes of entering your office. They haven’t even met the doctor yet, nor has a treatment plan been presented.

In other words, patients are not judging the quality of care provided by the doctor but the perception of the quality of care being demonstrated by the way every member of the team treats them and the way the team describes the quality of care being provided by the dentist.

Most patients joining the practice don’t know whether the dentistry being provided is exceptional or that the doctor is committed to excellent care unless someone tells them. This information is shared by the team, from the initial phone call to the new patient consultation through their recare visits. Endorsement of the doctor and his or her treatment by team members is not an option but a requirement.

Social media experts will state that Google reviews are critical to your social media presence. Patient reviews confirm that other clients have a high regard for the practice. Many patient comments refer to the way they were treated during their dental visit, not extolling the quality of the impression or the exceptional margin of the crown. All patient interaction is significant to their satisfaction and their opinion that they received an outstanding dental experience that was worthy of the fees charged.

From Awareness to the Phone Call

With few exceptions, the moment that patients call your office, they have chosen your care. Something inspired that person to call your office today, and that reason needs to be discovered. The responsibility of the receptionist is to find out the reason and validate that the patient made the right decision to contact your practice. The receptionist only has a few moments to make the right first impression.

Each team member plays a critical role in introducing the practice’s attributes and advantages. The hygienist has ample opportunities to discuss outstanding treatment plans and introduce new treatment possibilities during the patient visit. Being chairside with patients is an exceptional opportunity to communicate quality and endorse treatment. Together, they all validate the doctor’s treatment suggestions and extol the quality of care being delivered in their office.

There are myriad duties in the daily regimen of the dental team: orchestrating the delivery of treatment, arranging armamentarium, records management, and maneuvering the schedule to optimize chair time. In addition, the team members are responsible for communicating quality and perpetuating the practice culture. Demonstrating knowledge, empathy, enthusiasm, sincerity, and presence accomplish this.

Knowledge

Additional training to learn new techniques and technology will boost team confidence in talking to patients. A well-informed auxiliary can help patients better understand treatment recommendations. The more knowledgeable in materials, treatment processes, and technology your team members are, the more information they can share with the patient. Confirming the doctor’s diagnosis and helping define the treatment plan aids in patient understanding and promotes treatment acceptance.

A commitment to ongoing training keeps the team abreast in the latest clinical techniques and practice management. Providing in-office training programs and sharing journals and manufacturers’ materials for review helps the team stay current in dentistry.

Also, team meetings focused on patient communication familiarizes auxiliaries with patients’ questions and appropriate responses.

With the use of visual aids, the chairside assistant can explain treatment. Photographs, intraoral cameras, and media learning improve patient communication. The chairside assistant should be adept with learning technology to use these tools to augment patient learning.

Teaching the assistant to share patient information improves chairside efficiency and doctor/auxiliary utilization. This team member can assume a lot of the responsibility of patient communication while the doctor is attending to other treatment needs. Knowing the details of patient care helps the assistant become a “treatment ambassador” for patients and advocate for their care.

Empathy

Patients are looking for validation of treatment choices. They want the assurance that they have chosen the right office and the right doctor for their dental care. When the team introduces the practice philosophy and praises the doctor’s care, they are fulfilling the need for treatment validation. In essence, the team members become the second opinion that patients often seek.

Enthusiasm

The team’s excitement about treatment possibilities transmits to patients. Chairside assistants must convey their zeal for the practice. Praising the doctor and exhibiting enthusiasm for what the treatment plan can offer the patient in dental health and appearance translates to the patient.

When the staff is genuinely excited about the office and apparently proud of the doctor’s care, it captures the patient’s interest. Patients like to be surrounded by a team of professionals who exude confidence and show interest in their care. The enthusiasm of the team captivates the patient.

Imagine going to an amusement park and meeting apathetic employees who aren’t excited about the thrills and adventures the park offers. Would that change your experience? If you asked an attendant if the ride is fun or worth the wait, and in response you heard “I don’t know,” or “I have been on this so many times, it isn’t fun for me anymore,” would that alter your opinion? Or, if the employee said, “This is just my job, I don’t enjoy the ambiance anymore,” would you have a different perspective? I think you would.

Case in Point

During an in-office consultation in a practice, the doctor I was visiting was presenting his treatment plan and explaining its advantages. His chairside assistant was in the operatory with him, attending the consultation. During his discussion, he thought it would be helpful to use a current laboratory case as illustration.

The doctor left the room to get the restorations from the lab. I thought it was interesting that he got up to get the case, and not the dental assistant. But then I thought that it would be a great opportunity for the dental assistant to affirm the doctor’s treatment plan.

She could have taken these moments to comment on the doctor’s excellent care and the artistic talents and precision of the lab, while assuring the patient that the results of her dentistry would be worthy of her investment in time and resources.

After the doctor left the room, the patient turned to the dental assistant and asked, “What do you think about all of this?” Again, this would have been an opportune moment to validate the treatment plan and convey support of the doctor’s recommendations.

The assistant could have assured the patient of the doctor’s skill and care. She could have discussed the technical expertise of the laboratory and explained the importance of having synergy between the doctor and lab to achieve exceptional results. The assistant could have complimented the doctor and the lab and shared her pride in the process of treatment provided in the office.

Instead, the dental assistant turned to the patient and remarked, “Well, I have heard all of this before.” The atmosphere in the operatory made an obvious shift. When the doctor reentered the room with the lab case, the patient graciously attended to his explanation and then responded by saying, “Let me think about it.”

Upon reviewing this consultation, the team assumed they had “wasted their time” designing a comprehensive treatment plan for a patient who was limiting her treatment options to procedures covered by insurance. The team determined that they had failed to identify the patient’s status correctly.

There may have been something in that assumption, but I think something else happened. The lack of enthusiasm by the chairside assistant changed the direction of the patient’s motivation. In other words, the case was unsold.

Enthusiasm is infectious. Creativity and enthusiasm will outsell experience. Patients will respond more favorably to a positive, affirming team.

Sincerity 

Patient communication must be genuine. To be believed, the message must be heartfelt. Team members must communicate with authority and sincerity. Scripting may be a helpful tool in designing communication. But if the team member does not believe the message, the patient may feel the remarks rehearsed and contrived.

Spend time in helping the team understand and appreciate treatment philosophy, practice systems, and desired treatment outcomes. Create opportunities to ask for clarity and tools to help in patient communication in staff meetings and team dialogue. Describe and discuss your core beliefs to provide a clear understanding of your practice philosophy and design to achieve sincere endorsement.

The patient will witness care from all team members when everyone genuinely agrees on the core values of the practice. The message may be articulated differently, blending individuality with the philosophical foundation of the practice. But the core belief is the underlying theme in all communication processes.

Presence

To communicate effectively, team members must be fully present. This is more than physical attendance. The team member must be in the moment, paying attention to the words and watching for signs that the communication connection is successful.

Patients may be reluctant to tell the doctor that they don’t understand or haven’t fully grasped the treatment dialogue. This is when the chairside assistant or treatment coordinator becomes an interpreter. When the doctor is not in the room, the chairside assistant reviews information, confirms treatment recommendations, and asks the patient, “What questions can I answer for you?” This allows the patient to ask for more information and gain more assurance in the treatment plan and procedure.

Patients may be more inclined to voice their objections including financial concerns to a team member. An articulate team member should ask the patient to explain what is preventing the patient from having the procedure done.

The dental hygienist and assistant can take the time to listen to patient concerns, expectations, and questions. They become the liaison between doctor and patient. Time must be allocated to listen without interruption.

Appropriate body language telegraphs empathy and interest to the patient. The auxiliary should sit at eye level with patients, at their side, and slightly forward. Eye contact must be maintained with the patient. Looking at patients instead of the computer screen says that what they are saying is important and that you are paying attention.

How we communicate is 55% percent body language, 38% percent tone of voice, and 7% words. Paying attention to where you sit and how you stand as well as to the tone in your voice will make an impact.

The schedule must be structured to allow time to attend to patients in the operatory rather than leave them stranded while attending to non-patient duties. Sterilization time, chart completion, and preparing for patient care must be factored into patient treatment care to avoid leaving the patient alone to attend to these tasks. Patients want to feel well cared for, and they are more interested in how they are being treated, rather than if the next operatory is being stocked.

Sitting with patients while the doctor is out of the room or during a planned waiting period during the procedure also aids in the communication process. Using this time as an opportunity to discuss their care, their potential treatment results, and the additional services the practice can offer builds rapport and patient loyalty.

Data entry and record keeping are integrated in such a way that they do not take precedence over patient focus. Full attention is paid to what the patient is conveying, not what the response will be. Other distractions to patient focus are eliminated or minimized.

There are many tasks that need to be accomplished by the dental team, in addition to patient communication. What drives all of the practice tasks is patient care, which is improved when communication processes are the priority and fine-tuned.

Opportunities abound to improve and enhance communication. The result is that patient comfort is improved and treatment acceptance is increased. Patient satisfaction is achieved, and practice potential expands.

Ms. Engelhardt-Nash has been in dentistry and healthcare related fields more than 30 years. She is a founding member and has served two terms as president of the National Academy of Dental Management Consultants. She is currently serving her third term as President of the ADMc. She is a member of the American Academy of Dental Practice Administration and a Fellow in the International Academy of Dental Facial Esthetics. She also serves on the Practice Management Advisory Board for the ADA. She has been listed in Dentistry Today as a Leader in Continuing Dental Education and Dental Consulting since 2001 and the 2015 recipient of the Gordon Christensen Outstanding Lecturer Award. She can be reached at debraengelhardtnash@gmail.com or (704) 766-0025.

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