I had a patient in last week … we did an onlay prep on #30. Now she’s in pain. From what?! I adjusted the bite and told her we need to wait 24 – 48 hours to see if it’s a bite problem.
If it’s not the bite, then maybe it needs a root canal. She’s been online and doesn’t want a root canal because of all the information about root canal failures due to infection.
And, I agree … root canals fail more often than we recognize. We only ‘see’ the failure after its extracted and there is a granuloma or a cyst hanging off the end of the root canal tooth. And we think … well, this tooth hasn’t been successful for quite some time. The infection probably remained from the initial root canal procedure but didn’t show up on radiograph (or symptomatically) for a long time.
So, back to the patient above … this patient is battling some health issues and didn’t want a root canal. I understand. Why take the chance?
The rub: this tooth was prepped for an onlay … it was fractured (no caries). I addressed the fracture and hooded the working cusps. My differential diagnosis: it appears that the provisional may have been leaking and caused the sensitivity; or the nerve may have been insulted by the heat of the drill; or I just got too close to the nerve (or all of the above). No infection seen. Is the tooth in need of a root canal? Maybe. Time will tell.
If your 9-year-old fell over the handlebars and hit the pavement and broke #8 off into the nerve (not infected, just a traumatic incident), would a root canal be more successful?
I think … yes. You?
Wow, a robot dentist. Not true? It happened! In China, already! A robot has successfully placed two implants into a live female patient to an accuracy of 0.2 – 0.3 mm. The procedure was only assisted by humans in its initial step: a dentist initially oriented the machine to the patient and programmed the correct measurements and movements.
Where’s the USA in all of this? I thought that Africa wanting to become the first continent to be mercury free was aggressive … but now … the Asian continent has robots placing implants.
There are nearly 400 million Chinese in need of dental implants, yet just 1 million implants are placed each year. There are not enough qualified Chinese dentists to place this number of implants. In addition to meeting this unmet need, robotics should also dramatically reduce error rates and complications.
As with other professional services like law and medicine, many people (globally) simply do not have access to dental services due to the cost of inadequate supply. Robotics and Artificial Intelligence (AI) fill this need. Look for rapid adoption in China in the near term, and for those developments to filter into markets globally.
All of science in the 19th century and most of the 20th century was obsessed with looking for universals. Psychologists, medical scientists, and economists were all interested in finding out the rules that govern the way all of us behave. But that has changed.
What is the revolution in science in the past 10 to 15 years?
It is the movement from the search for universals to the understanding of variability. One size does not fit all. Now, in medical science, we don’t necessarily want to know how cancer works. We want to know how my cancer is different from your cancer. And, genetics has opened the door to the study of human variability.
To see if your patient is allergic to any of the materials you propose to use or would benefit from BioCompatible metal free dental work done, take a look at the patient’s health history.
Do you ask your patient “Are you allergic to aluminum (in Feldspathic porcelain), mercury, or titanium (implants)?” or “Are you taking immunosuppressant drugs (to see if the inflammatory burden of periodontal disease will be too much for their body)?”
Maybe your patient has a compromised health situation to begin with and is on 14 different meds and doesn’t have any immune system to spare to fight periodontal disease or deal with the dissimilar materials (allergens) that you are putting in the most powerful place on their body.
When we try to pursue universal principles in dentistry and think that any materials we place in the mouth should be fine, we are not just making a mistake.
2 + 2 = 5 … that’s a mistake!
What we are doing is a disservice if we think one size fits all.
Ask your patient. Just a thought. To be a better diagnostician. To help more. To earn more.
How do your thoughts, actions, body language, charisma, and empathy impact your business … your practice … your staff relationships … the acceptance rate of your best care by your patients? Do you think … “I want to know more about implant procedures and how to get my hourly rate higher. These other ‘touchy feely’ things … they’re not involved in the growth of my office.”
A long time ago, I wondered why the guy down the street (who graduated at the bottom of the class and hasn’t taken a CE course in 11 1/2 years) is burning it up and I’m sitting here rubbing two sticks together?
Do you know how he knocks it out of the park every month? It’s certainly not because he’s a better dentist. It’s certainly not because he’s taken more CE. I used to think that the more education I got … that would do it for me. I’d finally use my advanced education and get more dentistry off the shelf. Nope! Didn’t happen.
It turns out that it’s not about the next new procedure or the next class on sleep dentistry. It’s more about the behavioral sciences and the connections you make with your new patients. Applied psychology and the behavioral sciences are no longer thought of as just academic exercises. They are in the mainstream now and act as a social force like never before.
We find behavioral science information applicable to our professional lives as evidenced by the need for us to not only be a talented clinician, but to attain the status of “trusted advisor”. We know that it can take days, weeks, months or longer to attain this status. And so, we find it difficult to achieve “trusted advisor” status with someone we just met … the new patient. To speed up the process, the science of psychology and the behavioral sciences can be used to enhance the effectiveness of our relationship building from a lengthy time frame … to an instant.
So, what does this mean? It means that all facial expressions and actions will be picked up by your new patient, immediately and effortlessly. It also means that you can influence and persuade the new patient by simple body language and actions and expressions while you go through the new patient appointment. What you say, when you say it, how you say it … all now become profoundly important to guide the new patient in the direction of better health by accepting your best care.
What else does it mean? The behavioral sciences impact your paycheck.
I am hiring for a front desk position in the office. I sent out some feelers by word of mouth and I put out an ad on Craig’s List. And I came away with one question.
Is it hard to get hired? You bet it is. It’s really hard. Especially if you send out a pre-designed generic template … with generalized goals … and no more thought put into it than changing the date and then sending it out to as many people as you can find on Craig’s List who are hiring.
If that’s all you got, you better hope for some word of mouth help or have a friend who is leaving a position and recommends you, because out of the 30 responses to the ad, I got 2 (maybe 3) applicants who are worth looking at. The rest … well, here’s what I found out:
You’ve seen this yourself. Hiring is so tough! But, it’s even harder to get hired. Some of these applicants don’t have the history or the experience. Some of them are worth an interview and others … you wonder if you are wasting your time and theirs.
Putting an “A” team together starts with hiring “A” players. Hiring the next warm body doesn’t fulfill the purpose of the practice. It’s tough! But it’s great when you put it together. Everybody wins … you, the employee, the patient, the practice.
And that’s why the guy with the Psychology degree is worth a look.
Your ‘new patient’ comes from a variety of sources. But … your perfect ‘BioCompatible patient’ comes from just two! Your referral network and the internet will send you THE best BioCompatible patients, and you need to optimize your website to service this area of your marketing.
Don’t be Afraid! Some dentists are not comfortable with marketing. Some dentists don’t have a website. You need to deal with both if you want to skyrocket your BioCompatible referrals. The ADA is not checking websites for marketing correctness, and your colleagues down the street may see your print ads, but they are not online trying to find something to report to your State Board of Dentistry (they have too much to do just to keep their head above water). Online is the PERFECT place to market for BioCompatible patients!
Home Page on your website: Your website needs to address all of your features and procedures … and your BioCompatible procedures and protocols need to be right up front along with your Cosmetic and Sedation and other procedures. Be sure that you address your BioCompatible component on the home page. Patients who are searching out a BioCompatible dentist want to see and read A LOT about you. They want to know they are coming to the right office. So give them the intel. Don’t be vague … tell the online patient that you are mercury safe/you won’t judge them/you have other patients just like them/and you’re FUN.
Keywords: Have your webmaster use the meta-keywords that BioCompatible patients are using to search you out. Here are some of my keywords: mercury safe/mercury free/holistic dentist/holistic dentistry/amalgam free dentist/metal free crowns/biocompatible root canals/best holistic dentist/etc. Then, double your list of keywords by adding the name of your town to each one of the keywords.
Marketing: You will want to partner with several sites that promote holistic dentists. Some of these are Academies and some are promotional sites. Patients will find you online through sites like:
DAMS (Dental Amalgam Mercury Solutions)
IAOMT.org (International Academy of Oral Medicine and Toxicology)
IABDM.org (International Academy of Biologic Dentistry and Medicine)
HDA.org (Holistic dental Association)
Dr. Tom McGuire – DentalWellness4u.com
We don’t often hear what goes on up front in our offices. The front desk greets patients and they answer the phones and they check folks out.
All of the conversation seems to be fine. And that’s the problem. It all seems OK …
And that may be good enough for some practices. But if you are looking for a simple way to create a more pleasurable experience for every one of your patients, I’ve got an easy fix. Let’s start with the problem … one that you may not know you have.
It’s the slang of the language … usually on the street when younger people add on ‘nom sain’ to the end of a sentence. [BTW: ‘nom sain’ in English = “do you know what I am saying”] OK, OK, this is a lot more street talk.
The worst in the dental office? When a patient requests something and the staff member says … “not a problem.” Or worse yet – when a patient has a compliment or says something nice … and instead of saying “thank you”, the staff member comes back with … “not a problem.”
What are we really saying? “Don’t worry about it, ma’am, I didn’t go out of my way anyway. Not a problem.” Sure, that’s stretching it, but my point is this ...
Even if your response is the more standard “you’re welcome”, it’s still a very basic and lackluster response to another human … another who is expressing gratitude.
You’ll find a better response at the Four Seasons Hotel or at Chick-Fil-A … because it is part of their training. It’s required. It’s required because it acknowledges another person’s request or compliment with gratitude.
The response is … “my pleasure” … or … “certainly”.
Does it make a difference? Go to lunch at the Four Seasons … or go through the drive thru at Chick-Fil-A and hear it for yourself. It just makes you feel better about doing business with them.
Every new patient has a paycheck for you. It’s just waiting there... waiting for them to have a good reason to sign it over to you.
So what are the reasons they don’t want to give it up? Why did they come into your office and go through an exam and then decide not to follow through with the treatment you recommended (at least not your best option care)?
It all happen when you know how to offer your services with a great proposal.
Geez! If I could tell you in ONE sentence just how to get more of your best option care accepted, it would be to TALK TO THE PATIENT, IN THE LANGUAGE OF THE PATIENT, ABOUT WHAT MATTERS TO THE PATIENT.
This will answer 2 of the 4 questions above: a) use language the patient understands and, b) tie everything to their everyday life. When you can impact the patient at the center of their world and they can perceive the need for your care, their decision overrides the other issues of time and money. Folks just find the money and time to get what they NEED.
(BTW – when they see the need for your care, there is also a bit of urgency that goes along with it… lucky for us!)
The comfort of your financial future depends on your understanding of human behavior.
The more you understand human behavior, the more you can direct it. You might think that I am suggesting that we manipulate the patient to our way of thinking. Wrong! We are NOT villains. Our persuasion only helps the patient to accept care that is good for them. It helps the patient to have better health.
There are some brilliant minds in dentistry, no doubt! But there’s a hidden danger in being the brightest person in the room.
Now, no one has ever accused me of being the brightest person in the room. Maybe that’s why this “blog post” makes so much sense to me. Because if you are so intelligent that you rarely seek out advice, and you are the brightest person in the room, then you are in trouble.
It’s been shown that the approaches and outcomes of groups who cooperate in seeking a solution are not just better than the average member working alone, but they are even better than the group’s best problem solver working alone. Loan decision makers can’t match the diversity of knowledge and perspectives of a multi person unit.
Isn’t this risky?
Aren’t decisions that are made completely by a committee notorious for suboptimal performance? Well, yes … they are. So, follow this recommendation. Do not, I repeat, do not employ a vote counting strategy in order to come to a resolution. The final choice is always for the dentist to make.
The Staff Meeting.
If you regularly arrange for staff input, you can expect to achieve better outcomes. In addition, you can expect better relationships and rapport with your staff (which will enhance your future collaboration and influence).
Isn’t this risky (again)?
Don’t you run the risk of bruised egos and lost motivation if a staff member’s idea is ultimately rejected? This shouldn’t occur as long as you assure that each staff member’s ideas (while perhaps not the deciding factor) will be considered in the process. Staff members feel appreciated when they are recognized and acknowledged for their efforts and contributions.
This is good news and bad news for you!
I am going to sell you “tomorrow” … two different ways! I am going to sell you for the health of your local community and I’m going to sell you for the health of your patients/your practice.
You don't really think I can sell “tomorrow”, do you?
You probably think that ”tomorrow” doesn’t come cheap? So, I'll put my money where my mouth is … because a dentist has much more power than the normal citizen when it comes to toxic waste and tomorrow’s health of our communities.
Don’t be offended … but, you have the power to pollute. It’s actually been estimated that you (we) are responsible for 40% of the toxic mercury spilling into your (our) local Waste Management Plant(s). It then becomes a problem of bioaccumulation of a toxic metal. And because mercury is an element, it cannot be broken down into anything less toxic. It can only be contained. And the Waste Management Plants aren’t set up to do this.
So contain it. Contain it to protect your local environment and for the global concern (there are global treaties being developed right now for controlling and containing the bioaccumulation of mercury on the planet). It’s a problem.
Now, I know that thinking globally is difficult. I get it. But there is something you can buy. Yeah, the least you can do is throw money at it.
Buy “tomorrow” - right now. All you have to do is install a mercury retrieval system … simple. And it’s voluntary for the vast majority of states … but not for long. The EPA is going to require all of us to install a mercury retrieval system. So, stay ahead of the curve … you’ll probably get some great press because of it too! The local media LOVE this kind of health angle.
OK, this is a no-brainer, because we’re going to be forced to do it anyway. Stop the mercury flow into your environment.
The second way I want you to buy “tomorrow” will not only benefit your local environment, it will benefit your patient’s whole body health and your bottom line. Your patients will be healthier tomorrow … and the health of your practice will increase tomorrow as well.
And all you have to do is take your mercury free practice … and make it a mercury safe practice.
You can do it by adding a profitable BioCompatible component to your practice (now we’re talking about money). You don’t have to turn your office upside down/you don’t have to go to weekend after weekend of training/you don’t have close your office and lose production/you don’t have to send your staff to CE/ … it’s much simpler than this.
You put in some relatively simple yet tremendously powerful enhancements to what you’re already doing … and BINGO … the results can be nothing short of astounding.
The simple measures you take will not only help your local environment but also protect your staff and your patient every time (i.e. every day) you remove a mercury filling.
It’s going from mercury FREE … to mercury SAFE.
And here’s the kicker … you’re already mercury free … you’re almost there anyway.
So, by adding a BioCompatible component to your practice, you will be realizing the most profitable business model in existence for the general dentist. Yes, there’s a big benefit in selling “tomorrow”.
Winner – the health of your local environment (this is the good news)
Winner – the health of your staff and patients (this is the good news)
Winner – the health of your bottom line business (this is the good news)
It seems to be a harder sell than it should be (this is the bad news). Especially, when you know that everybody wins.
It’s harder than it should be, because you don’t know where to start. Well, with this natural evolution of dentistry, I may not know the ending, but I know where to start … now!
Dr. Peter Evans is a practitioner, author, speaker and international dental coach. He is the President of The BioCompatible Dentist, LLC