Optimal Answers

Sept. 1, 1999
Are you bombarded with questions during the patient education segment of an appointment? Your answers remain the most influential aspect of `optimal dentistry.`

Are you bombarded with questions during the patient education segment of an appointment? Your answers remain the most influential aspect of `optimal dentistry.`

Cynthia McKane-Wagester

During the last 20 years, preventive maintenance (recare appointment) has evolved enormously. Commonly known to our patients as "the cleaning," this 50 to 60 minute appointment with the hygienist has become the foundation that empowers patients towards a lifetime of ideal dental health. As master dental hygienists continue to strive to become the best, it is imperative that they be extraordinarily competent in their clinical skills, as well as extremely versed and knowledgeable in the use of all the dental products that can be given to patients to better their health.

The hygienist has become one of the front-line educators of "ideal dentistry" largely due to two factors. Hygienists have the most time to educate and teach, and they have the tools at their disposal that can keep patients healthy. National statistics tell us that between 40 to 80% of dental care needs are found during the hygiene appointment. This means that the hygienist must be willing and committed to educate patients. The goal is to raise dental awareness to the highest level.

If the dental team has not yet discussed the practice`s vision and philosophies, then the practice cannot expect to achieve optimal acceptance of treatment plans. The purpose of communicating dental value to our patients is not just to "sell them" something. The purpose is to guide the patient through a series of steps which will result in the patient accepting the appropriate treatment to protect, strengthen, and improve the overall appearance of their teeth for the rest of their life.

Eighty-five percent of our patients will move toward behavior that makes them feel good or positive, shying away from behavior that makes them feel bad or negative. This is why experts tell us that we need to create the "want" in the patient`s mind. Patients do not buy what they need; they buy what they want.

How we go about this is dependent on not what we are saying but how we say something. Are we showing patients our sincere concern for them? Do patients think of us as a true friend who is working to assist them in every way we can? Do we inform patients that we are a part of one of the best dental practices in town, that we have their best interests at heart?

What we must do first is, of course, build a wonderful, trusting relationship with the patient and reinforce to them our sincere interest and commitment to providing them with the absolutely best treatment appropriate for them. The dental hygienist establishes the needs and wants of the patients and explains the best way to satisfy them. Only minimal reinforcement is needed from the dentist in encouraging the patient to accept the presented treatment plan. The dentist agrees with or improves the plan initially presented by the hygienist.

When working with patients, the tone of our voice should be enthusiastic. We must be assertive and have good eye contact. Remember that body language represents 80 percent of communication. How we say something can impact our credibility positively or negatively. We must believe in ourselves, believe in our dentistry, and consistently communicate to patients that the treatment we want them to accept is absolutely the best therapy for them. If there is the least amount of doubt in the hygienist`s mind, the patient picks up the body language and "feels" the indifference oozing from our pores.

We are bombarded every day by the same questions from patients. Why do I need a fluoride treatment; I heard fluoride in my water supply is enough? What is a sealant? Do they really work? Why would I want to spend so much money on an implant? These questions and others are asked of the hygienist everyday.

Our responses may have a positive or maybe even a negative impact on the patient. The hygienist must be prepare the responses and memorize them so that the same statement or response consistently used (this consistency also has a positive effect on patients). The response should evoke comfort within patients that the suggested therapy is, indeed, the best one for them.

Cynthia McKane-Wagester, RDH, is the founder of McKane & Associates, a full-service management company servicing health care practices. She can be reached at her offices in Maryland (800) 341-1244.

What everyone is saying...

Schedule a team meeting for approximately four hours and prepare responses to the questions frequently asked by patients. Practice the answers, stand tall, value yourself, remain confident, and communicate effectively your knowledge and belief in your product, which is dentistry.

Dental hygienists should be familiar with the dental products and services listed below. How do your pearls of wisdom stack up against the information presented by colleagues in the office?

During the meeting, all staff members should write down a summary of what they say about a particular product or service on a 3-by-5 index card and see that everyone gets a copy. The staff should then maximize the presentation process by preparing statements to be used in the operatory during patient education.

Begin to practice the responses. Every member of the team needs to be consistent and competent! Remember, practice makes perfect!

Queries about products and services

- Whitening (bleaching, both in-office and at-home)

- Electric toothbrushes

- Fluoride medicaments and programs

- Antibiotic therapy

- Periodontal rinses

- Micro-abrasion technique

- Tooth-colored onlays/inlays

- Crowns

- Veneers

- Bridges

- Implants

- Composite restorations

- Sealants

- Night guards

- Occlusal splints/occlusal problems

- Endodontics

- Periodontal surgery

- TMJ therapy

- Oral surgery

Common questions during treatment

- Why do I need X-rays? Are X-rays dangerous?

- Why can`t I have a filling rather than a root canal?

- Do we have to save it if it`s only a baby tooth?

- Why can`t you do this without a shot?

- Why doesn`t my insurance cover all this? They said it would at work.

- Is this going to hurt?

- What`s the difference between a bridge and a partial?

- What`s the difference between a cap and a crown?

- Aren`t plaque and calculus the same thing? What`s the difference?

- How often do I change my toothbrush?

- How often should I have my teeth cleaned?

- Why do I need fluoride? I heard fluoride might be dangerous.

- What are those sealants? Do they really work?

- Why do you have to clean my teeth before doing the front tooth filling?

- Why do I need to take pre-medication?

- Can`t I come in at 4:30? Or on Saturday? Do you have Saturday appointments?

- Wouldn`t it be less expensive to just pull my tooth?

- Can you tell me why you autoclave your instruments?

- My teeth have always been bad. Wouldn`t dentures be easier/better?

- Why are all of my new fillings sensitive?

- Why do I have to see a specialist? (endo, perio, oral surgeon)

- Why do I need a crown?

- Can`t you just put in another filling?

- Aren`t crowns expensive?

- What`s the difference between silver fillings and white fillings?

- Gosh, that onlay sure is expensive. Why is it so much money?

- I heard periodontal surgery doesn`t work ... Does it?

- What is root planing?

- Why do I need to come back again to get my teeth cleaned again?

- I don`t need fluoride! Anyway, insurance does not cover it.

- I know the dentist just wants to buy a new car, doesn`t he?

- I really do not have the money. What should I do now?

Questions about post-operative instructions

Also commit to paper the post-operative instructions for the following dental therapies and practice your presentation:

- Crown and bridge temporaries

- Crown and bridge at home care

- Extractions

- Wearing of TMJ splints

- Orthodontic braces

- Periodontal surgery

- Injections, I.V. Sedation and Oral Sedation

- At home bleaching instructions

- Restorations - Composites and Gold

Pearls for Case Presentations

If you will consider implementing the following pearls, your case presentation style and acceptance levels will improve:

- We are committed to establishing caring and compassionate relationships with all our patients, and we always try excel in customer service.

- We avoid using technical words when describing our therapy.

- Our office always greets a new patient and "treats them as a guest in our home."

- Our office uses a "getting to know you" form for new patients.

- A welcome letter or welcome package is sent to all new patients prior to the first visit.

- During appointments, we use open-ended questions, encouraging patients to share their thoughts and not just answer yes or no.

- We always instill the value of optimal dentistry and how it relates to oral health.

- We always focus on building lasting relationships with our patients and always share the philosophy of practice with all patients to see how they feel about long-term dental health.

- Our operatory is filled with the most advanced educational tools for our use.

- Recent surveys indicate that 68 percent of patients do not return to an office because someone projected an attitude of indifference. Our attitude is always positive, upbeat, and reassuring to both new and old patients?

- While the patient is talking to us, we look for the non-verbal communication signs. We quickly change our approach towards the patient so the communication is proactive.

- Our team is very consistent in its policy protocol. Inconsistency can make us look unorganized and very unprepared.

- Optimal treatment plans are always presented first. This is because we believe in ideal dentistry and its benefit to our patients.

- All of the team, along with the doctor, always proactively educate the patient towards accepting ideal dentistry.

- We will continue to be animated in our presentations, so our "passion" shows through. Remember that it is not what we say, but how we say it that is so important.

- We participate in daily morning organizational meetings in which we review dental treatment plans that still need to be presented.

- The team always uses a closure statement. "Mrs. Smith, since you have no further questions, I really don`t see a reason why we shouldn`t go ahead and schedule this therapy. Is this agreeable to you?"