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Stop selling dentistry: Contributing to production with empathy

Feb. 1, 2019
By taking the time to have conversations with patients, dental professionals can find out what they want, and then determine how staff and patients can reach those goals together.

Christa Crilley McConaghy, PHDHP, RDH

Hygienists’ contributions to office production are not based just on what we produce in our hygiene chairs, but also on what we present to patients as future treatment in the dentist’s operatory. Many of us ask ourselves how we can attain our treatment presentation goals and maintain our professionalism yet not appear as if we’re desperate for a sale. We need to stop selling dentistry!

Most morning huddles start with the team grabbing their cups of joe and spending 15 minutes reviewing charts and the incomplete treatment plans that go along with them. In order to provide years of oral health care to patients, the office needs to stay in business, which ultimately means the team has to make money. That’s where our jobs in sales begin.

Our patients don’t need us to sell them on services they don’t need. Our patients present to us with problems every day. They may not even realize the issues they have until we review our dental hygiene diagnosis and show them their x-rays and intraoral photos. Their needs already exist—we need to look at what can cause problems for them and educate them so they understand the problems and ask us for solutions. With this approach, we don’t sell dentistry; we sell an outcome.

Here’s what I mean. Have you ever asked your patients what their goals are and how they hope to reach them? We usually know what their best course of treatment is, and we often tell patients what to do without having a conversation.

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Years ago, I actually asked a patient what she wanted. I did not expect to hear what she had to say. Like many fearful patients, this woman I will call Mary had been absent from the practice for years. This was my first appointment with her, and I could tell that she was reluctant to be back in the dental office, especially in the hands of someone she didn’t know. I knew I needed to get to know her so that I could address her needs and make her feel comfortable.

Asking questions was the only way that I could figure out why she came back after her long hiatus. After x-rays and a full periodontal charting, in which her numbers were higher than 6 mm and she had bleeding around almost every tooth, I asked her a question no one had asked her before. “Do you want to keep your teeth?” Her answer surprised me. She said, “I’m not sure.”

It’s amazing how asking a simple question opened the door to a long conversation. She had had problems with her oral health for years, but no one had taken the time to actually talk to her and listen to her responses. We spent her entire appointment talking about options. Her parents had dentures, and she didn’t want to take the same path but felt that she was getting closer to her destiny and that she had no alternative.

Mary told me that she was an avid wine taster and didn’t want to alter the taste of her favorite wines by covering her palate with dentures. She knew that some teeth would need to be extracted, but she was happy to learn that many could be saved with nonsurgical periodontal therapy and Perio Protect trays, which help reduce inflammation and control biofilm. She wanted to keep her teeth and taste wines like she always had.

Learning this could be achieved was the motivation Mary needed to move forward with treatment. She had never before been asked what she wanted, so had she never voiced her concerns. This led to a decision that would not only benefit her but the office as well. Agreeing that there was a need and determining the outcome was only the first part of our conversation.

We determined her reason for treatment and the outcome that she wanted, but we had other issues to overcome—cost, time, and fear. These are often the reasons our patients don’t follow through with scheduling their appointments.


Patients are always curious about what a procedure is going to cost them and rightly so. Here’s where our detective skills come in so that we can find out what they expect for their outcome. Now’s the time to ask if they want a short- or long-term solution. You may see a tooth that needs a crown, but the patient may only want what their insurance covers.

For example, a study done in 2012 determined that 90% of restorations will need to be replaced after 10 years.1 Does the patient want to replace fillings every decade, or would the person like to accept the treatment that will be most cost effective in the long run?

In Mary’s case, we scheduled the start of her treatment in September, and we were able to schedule some appointments during the current year and some the following year so that her treatment could be completed with some benefit from her insurance coverage. We determined what she could afford each month and used a health-care financing company to subsidize the costs.


Time is money, right? In a world where time off from work can be detrimental to a person’s employment status, our patients need a schedule that works for them. Asking a patient to stay and catapulting them directly from the hygiene chair to the doctor’s chair for a procedure can add to the bottom line of the practice and avoid a scheduling issue for the patient. Keeping them in the office to finish dental work is a win-win for everyone as long as there is room for flexibility in the practice. Being efficient when treating patients will keep chair cost down and allow for more productivity.

We took Mary’s impressions for her Perio Protect trays while she was in the office so we could streamline the number of appointments she would need. This helped her avoid extra time off from work.


Lastly, fear is a major issue that complicates the world of dentistry. Many patients fear feeling out of control. They may also fear being in pain. Openly communicating with patients and keeping them informed about what is happening or is about to happen can ease their emotional discomfort. Keeping the lines of communication open helped us gain Mary’s trust, which made her future appointments less stressful.

What reaction do we want from patients when we speak to them? We want them to accept our treatment recommendations. Motivating patients means switching our focus from selling (advertising) to educating (marketing). Do we do dentistry, or do we create healthy beautiful smiles? We have the opportunity to gain acceptance by offering patients the outcomes they desire that will motivate them to accept treatment.

When we put patients first, we’re not selling them dentistry but guiding them to health by asking the questions they should answer in order to make a decision. Standing in our patients’ shoes and understanding their thoughts and expectations gives us the opportunity to educate them and allow them to buy the outcomes they desire. This is how we stop selling dentistry and give our patients what they want.


1. Heintze SD, Rousson V. Clinical effectiveness of direct class II restorations–a meta-analysis. National Institutes of Health website. Published August 2012.

CHRISTA CRILLEY MCCONAGHY, PHDHP, RDH, has been an RDH for over 20 years and received her BS in oral health-care promotion from O’Hehir University. She is currently a trainer for Perio Protect and a presenter for the Healthy Teeth Healthy Children program, a medical/dental partnership that works to increase dental access to children. Her career goals are to improve oral health care by implementing disease prevention programs.