Marketing in the Aisles of Prevention

The game of bucks, flash, and gimmicks has an awful lot to do with whether your recommended products appear on the shelf.

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By Anne Nugent Guignon, RDH, MPH

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Have you ever wondered about the marketing of oral-health care products in the retail sector? From my perspective, I just wanted my patients to be able to get the recommended products without a hassle. If they needed a very special device, I knew they could go to the local pharmacy. If products were not on the shelves, then surely the pharmacist would order the necessary supplies. Ah yes, those were the pre-Wal-Mart days. Today's shelves are stocked with the supplies that the folks from ACNielson (yes, these are the folks that determine TV ratings) or Information Resources, Inc. have determined are the hot sellers — not what our patients may need to keep their teeth for a lifetime. It is a game of bucks, flash, gimmicks, shelf positioning, and presence in the market that determines what our patients are able to purchase on the retail level.

Here is the skinny on what really happens when people go to the store to purchase a brush or other oral care product. The marketing forces in America have divided the retail market into three categories: traditional drug stores like Walgreen's and Eckerd's, grocery stores like Kroger, and mass merchandisers like Wal-Mart and Target. If you were on Jeopardy and had to identify the largest retail market for oral health care products, which would you choose? If I were a betting person, I would have placed my money on the drug stores ... and I would have lost.

Grocery stores are the market leaders for the sale of oral care products. Who would have figured? Dental professionals are consumed with patients selecting the exact product that will make them disease free. Unfortunately, purchasing just the right dental product may be item number 20 on a list of twenty when they go shopping! Here's a clue: The rest of the world does not place the health of their pearly whites at the top of the list!

So how do our beloved oral health-care products find their way into your patients' hands via the local grocery store shelf? I confess that I was naive. I thought products were in the stores based on consumer demand, but I was in for a rude awakening! Here are the hard facts straight from the mouth of a sales and marketing agent also known as food broker. Brokers are the people who represent various product manufacturers. Their goal is to get the products that they represent on the shelves and provide value-added services for the manufacturers they represent. They are charged with securing the highest profile shelf space possible. Shelf space is a very precious commodity. High dollars are at stake here. According to a grocery store trade organization, called the Food Marketing Institute, chain supermarkets of all sizes represented 82 percent of all supermarket sales in the country in 2001, accounting for more than $398 billion dollars in sales. That's a lot of toothbrushes, pork and beans, and dishwashing liquid.

Twenty years ago, life in the oral health-care product aisle was very simple. All brushes were about the same. Butler had the rounded dome-cut bristles, and Oral-B still had a rectangular head. Other than that, all toothbrushes had clear bristles and all the handles were straight sticks. Padded handles, colored bristles, angled heads, ergonomic handles, slanted bristles, flexible heads, special handle grips, and short and long bristle mixes were just a gleam in the developers' imaginations. Even less attention had been paid to floss and mouth rinses.

Even though today's manufacturers devote a tremendous amount of time and attention to producing quality oral health products, the product has to appeal to the consumer.

Innovation is another key to boosting sales of any product. According to the grocery store broker, innovation in oral health-care products started years ago when the Reach toothbrush hit the market. As soon as the Reach brush showed a rise in sales, the race was on. Oral-B developed brushes with longer bristles at the tip end. Now they have introduced the CrossAction brush. Colgate entered the arena with Wave's diamond-shaped head and ergonomic handle. Procter & Gamble developed the Flex head, and Mentadent's brush was designed with a wide body and low-cut center bristles. While design changes have many technical merits, they also help capture impulse sales.

At the top of the food chain

Grocery stores love the toothbrush wars. The average markup for a food item is 15 to 20 percent. Specialty foods have a slightly higher profit margin, but the markup on toothbrushes and toothpaste is somewhere between 35 to 45 percent, resulting in a lot more profit on the sale of the newest hand brushes vs. a package of frozen green beans.

Toothpaste has carved its own little niche in the supermarkets. Years ago, marketing studies indicated that consumers like toothpaste that foams a lot and, as a result, brushed longer, thinking that the foaming action had a therapeutic benefit. Marketing gurus call this the "foaming dog effect." Line extensions are another marketing concept that comes into play. Toothpaste products have many examples: tartar control, whitening, sensitivity and anti-gingivitis formulations. Line extensions keep the products on the shelves. Innovative dispensers also help sell products. So you remember when Mentadent's toothpaste came out in a pump dispenser? Patients were fascinated with the packaging and its contents. Dual paste dispensers had been around for a few years but the pump dispenser was a whole new packaging design. Today's grocery store shelves even have Mentadent refills available. Despite the efforts of various manufacturers, the big three in the toothpaste world are still Crest, Colgate, and Aquafresh.

Whitening products are hot in today's market. Crest White Strips have captured the attention of consumers all over the country. Displays in local retail establishments invite customers to view how their teeth could look when they look at their pearly whites in a blue tinted mirror. How many times have you fielded questions from patients in your chair about the effectiveness of the White Strips or OTC whitening toothpastes?

Undoubtedly, you are aware of the enormous popularity of the Listerine Pocket Packs. The product is everywhere and the stores just can't keep it on the shelves. Similar products by other manufacturers are popping up everywhere. It's amazing that so many consumers are willing to plunk down more dollars to defeat bad breath concerns when thorough oral hygiene practices such as brushing, flossing, and tongue cleaning will go a long way to alleviate their concerns. If we are smart enough to put a positive spin on products like this, we will see this as an opportunity to discuss the merits of a variety of oral health-care products.

Healthy or merely profitable?

It was disappointing to learn that grocery store retailers probably do not know the difference between the various types of oral rinses. Apparently, there is only so much shelf space that can be devoted to rinses. Retailers are the experts in moving products off the shelves — not preventing caries or periodontal disease. It is unlikely that the retail decision-makers understand the difference between the benefits of a therapeutic rinse containing fluoride vs. rinses that claim to attack plaque or destroy bad breath. Names like Act and Plax may not sound very different to the consumer, but every dental hygienist recognizes that rinsing is the only similarity between these two products. Listerine rinses are the market leader in the rinse category and the manufacturer continues to provide extensive support in the form of advertisements, coupons, retail displays, and support in the local dental offices.

Another factor to consider is the profit derived from the thousands of items lining the shelves of the health and beauty aisles, known in the grocery trade as HBC. Most items in the HBC section of the grocery store are relatively small, but the vast majority are high-ticket items such as a toothbrush or a tube of mascara or lipstick. Since the markup on these items is high and these aisles are dense with products, a lot of money can be made in the HBC aisles. Think about the amount of space that the boxes of Rice Crispies take up on a grocery store shelf. Now consider how many racks of toothbrushes or floss can be jammed into the same amount of shelf space.

The high-cost, densely packed HBC items, though, suffer from a phenomenon known in the marketing world as "shrink risk," which is the amount of potential shoplifting risk that a group of products face. While it is unlikely that someone will risk being sent to jail over stealing a 79-cent can of applesauce, the same person might find the thought of shoplifting a $4 toothbrush or $12 compact worth the gamble. As a result, even though the dollar profit from the HBC aisle has a potentially high rate of return, a much higher security risk than any other area in the store offsets this. In the grocery market, this is known as the most expensive real estate in the store. It is unlikely that these areas will be expanded to hold a wider variety of home care dental products.

Grocery stores also tend to prefer products that have a lot of support from the manufacturer. Items that have a lot of visibility in the form of TV and magazine ads, coupons, and grocery store ads gain favor. Larger dental product manufacturers also have representatives who visit individual grocery stores and build product displays, often at the end of the aisles. Grocery retailers also consider the amount of support that companies give to dental professionals. They are more likely to give shelf space to a product if manufacturer representatives visit local dental offices to promote a product, often providing the hygienist or dentist with literature or discount coupons to give to their patients.

The plot gets even thicker. Remember those ACNielson folks? Just about every supermarket scanner is hooked up to one of two major agencies that conduct volumetric studies. These agencies know about every single sale, at every single store, of every single product. Not only do they know what is on the shelves in this country, but they also track the sales in 130 countries worldwide. They have incredible stats that include when a product is sold or when it is on promotion, or the market share of your favorite product.

Today's marketing relies on keeping very limited inventories on the shelves. Space is money and new products have a six-to-nine month opportunity to make the grade. Ninety percent of all new products are gone within the first year of introduction, so it is easy to see why your favorite product may not be on the shelves the next time you stroll down the aisle.

Isn't it great that companies spend time and money to develop innovative products and then apply clever marketing strategies to get their products into the hands of consumers? New products can add excitement to the same old story.

Don't you just love it when a patient comes into your treatment room asking about the latest brush or mouth rinse that they've seen at the grocery store? We've just been given anther golden opportunity to show them how much we know about oral health and disease ... and just how much we care!

Author acknowledgement: Jeff Folloder, vice president of CROSSMARK Consulting Practice, provided much valuable assistance with this article.

Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. She writes, speaks, and presents continuing-education courses on ergonomics and advanced ultrasonic instrumentation through her company, ErgoSonics (www.ergosonics.com). She can be reached by phone at (713) 974-4540 or by e-mail at anne@ergosonics.com.


A fight for space ... and your attention
Whether or not a product actually makes it to the shelf in the first place is often a result of what is known in the retail world as a slotting fee. In other words, most companies pay a special premium to the grocery store chain just to have their product place in the store's distribution warehouse. Quite simply, if the product is not in the warehouse, it will never make it to the shelves. When the grocery store is considering a new product, the slotting fee may be waived if the product is coming from a well-known company with a proven track record of high sales. That is why it often feels like the retailers are operating with a here today, gone tomorrow mentality.

Market specialists and grocery store retailers know that people buy on impulse. Certainly each one of us has arrived home from a trip to the supermarket with items that were never on the list we took to the store. Did the unplanned purchases secretly jump into our shopping carts as we cruised down the aisle? Of course not.

Retailers know that few people walk into the grocery store intending to buy a toothbrush. They develop strategies to boost the impulse sales. As the unsuspecting shopper rounds the end of the aisle, they are met with one of those clever displays overflowing with the newest brush on the market. The plan works and Suzy Shopper grabs an extra brush or two and drops them in her cart.


A belated visit to the store
How does the average dental professional find out about new products? You know the answer. We receive samples in the mail or from exhibitors at dental meetings. Many companies place large ads in our professional journals. Others have representatives who stop by our offices. When was the last time you actually purchased a toothbrush for your own personal use? Companies want us to recommend their products so they put them in our hands for free.

Since I really couldn't remember the last time I took a trip down the dental aisle in my local supermarket, I decided to get a firsthand look at the choices available to today's consumers. Sure enough, I recognized all of the products and strategies that I had learned about, but there were things that I didn't expect or even know existed. Yes, the expected toothbrush and floss displays were there. But, a decade ago, my local grocery store never had specialty items such as bridge threaders and interproximal brushes, much less orthodontic wax and personal home scalers. I also saw that Mentadent now comes in refills, no longer wasting precious landfill space on disposable containers. One toothpaste is even being marketed as a liquid gel formula — similar to hand washes or bath gels. The product claims to be a combination toothpaste and mouth rinse. Simple, inexpensive power brushes are even occupying shelf space in the grocery store these days.

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