Dr. Peter Evans, DDS

If your patient is experiencing their dental hygiene care as a prophy, a brush and floss lecture and quick dentist check at the end, then you are NOT getting the most out of the most powerful 5 ½ minutes in your hygiene appointment.

You want to have patients accept your best recommendations, don’t you?  They usually come to the office prepared to accept our recommendation.  But patients don’t start buying 

 dentistry until they stop getting cavities, believe you are knowledgeable and know they won’t be sorry. 

Practicing dentistry is successful when the dental hygienist becomes a risk factor preventive specialist and the dentist diagnoses dentistry for whole body health.

Rules are everywhere and most of us try very hard not to break the rules. But rules in dentistry keep us in the commodity business.

		Basic rule #1: keep your focus only on teeth and gums (under pain of death).

 wasted exercise. This narrow focus misses the consequences seeing how dentistry impacts whole body health.

The 80-20 rule, or Pareto Principle, is the idea that a relatively small percentage of any cause (20%) creates most of the subsequent effects (80%). In dentistry, teeth make up only 20% of the surface area of the mouth, with the other 80% including interproximal spaces, the dorsum of the tongue and cheeks, and below the gum line. Yet this still misses a lot.

We are moving beyond the purely mechanistic/treatment view of oral health because the mechanical model of dentistry keeps us in the tooth and gums fixing business. The natural progression of our profession is plotting a course for risk based/diagnostic centered model of health. It’s time to break some of the old and create some new rules.

Percentage of the population with a dental visit from 2000 to 2011.

Bringing patients into our practices has remained the same for all these years. Maybe (through a CE course here and there) you added or subtracted a step or two.

But, whether patients enter through the dentist or hygienists’ chair, the pattern remains the same … fill out a health history, gather oral data, take some x-rays, and have a prophylaxis before the dentist comes in and ‘looks around’. This has been the old equation for productivity. But that equation doesn’t work as well as it once did, people want (expect) more.

Demographic studies are showing the population between ages 19-64 (the majority in most of our practices) is trending down in the number of visits (Figure 1).  Where are they being seen? The trend line for the younger adults, ages 21-34, has sharply increased over recent years and they are seeking care at emergency departments of hospitals (Figure 2).  Oh, that’s just the economy or because they have no dental benefits.

Dental emergency department visits as a percent of total dental visits in the United States. 

Those answers can feel comfortable to us, yet a deeper look shows many are looking for alternative health care possibilities.  Dentist’s income trends are also being affected by these shifts (Figure 3).

Market dynamics in the dental care system.

The facts are … that 30% of the American population is recycling and going green, and 30 – 40% is pursuing alternative health care.  These numbers are just too big to ignore anymore.  There were more patient visits to Naturopaths, Chiropractors and alternative medicine providers than there were to traditional medicine providers in 2013.   

 Lifestyles of Health and Sustainability (LOHAS)

. This is the biggest market you’ve never heard of.  And profits will suffer the longer you ignore this market.  Go ahead and google it and break the rules. There is a HUGE opportunity here.

The innovative dental team is evolving right along with the new research and science. And the nice part of this evolution is that it is effortless. We already have the education and most of the equipment to increase the effectiveness of helping our patients and our business bottom line. Think of it as progress in 

Working Together with the 7 Diagnostic Disciplines

 hygiene check as a rule must be broken.  And we break this rule by understanding that whole body health is more than just teeth and gums. Risk assessment and co-diagnosis with an emphasis on the 7 Diagnostic Disciplines (see table 1) gives patients what they are looking for and improves patient care. You and your team will be more productive and this translates into greater personal, financial and professional satisfaction.

Patti DiGangi, RDH, BS is a clinician, speaker, author and coach. She is an ADA Evidence Based Champion and holds a publishing license with the American Dental Association for Current Dental Terminology. She is the author of the 

 series of mini-books. She was awarded the 2014 Sunstar Award of Distinction, 2014 CE Leaders Recognition and 2013 Sonicare Mentor of Distinction.

Dr. Peter Evans is a practitioner, author, speaker, and inter-nationally known dental coach. He is an active member of the American Association for Oral Systemic Health, Academy of General Dentistry, American Dental Association, International Academy of Oral Medicine and Toxicology, International Association of Mercury Free Dentists, and Holistic Dental Association. They join their strengths to offer their course - 

. For information, contact Kristin Church 

Articles

Untapped Power in 5½ Minutes If your patient is experiencing their dental hygiene care as a prophy, a brush and floss lecture and quick dentist check at the end, then you are NOT getting the most out of the most powerful 5 ½ minutes in your hygiene appointment.