Practice Wisdom: Presenting Elective Dentistry

Feb. 1, 2006
I am a general practitioner in the Northeast, and I’ve practiced dentistry for 20 years.

Dear Dianne,

I am a general practitioner in the Northeast, and I’ve practiced dentistry for 20 years. During the past 10 years, I have devoted time and expense in cosmetic dentistry. Of my three hygienists, only one seems interested in promoting my cosmetic services. I have talked to them as a group and shared my wishes, but it does not seem to change things. We track which provider presents treatment and when that treatment is scheduled. I’ve found that 80 percent of cosmetic treatment is sold by one hygienist. How can I get my two other hygienists talking about and promoting cosmetic dentistry?

Dear Harriet,

I suspect that the two who are not presenting treatment feel uncomfortable. Most likely, they need to develop verbal skills. They need to be familiar with the procedures you do and know about benefits for patients.

In my experience, a good communicator becomes great with an intraoral camera. Your hygienists should be skilled in its use and have sufficient time allotted during appointments to talk with patients. Much hygienists’ treatment philosophies come from how their doctors practice. Some doctors do good ole basic bread-and-butter dentistry. Others steer toward cosmetics, orthodontics, treating craniofacial pain, holistic dentistry, and the like. Have your hygienists watched you work with a cosmetic patient? Have they watched you prep and complete a case? Or do they just get to see final products? Do they need cosmetic dentistry or bleaching? You can create a missionary by treating a staff member’s family member for free or at a reduced rate. A hygienist must be sold to promote you.

Is personality a factor? Some people enjoy talking while others are content to only speak when spoken to. Nevertheless, even an introvert can become an effective marketer if given the right verbal skills.

Verbal skills

Your best referrals come from satisfied patients who show off their beautiful cosmetic dentistry. Those patients come to you ready to improve their smiles. Hygienists only need to affirm and support them and you.

More than likely, you are concerned about the patients in your practice who have treatment plans that have not been scheduled, or patients who could benefit from some type of elective dentistry if someone presented it to them. Good verbal skills are critical. Patients who feel pressured likely will leave your practice. Find out how patients feel about their oral health and smiles with a few brief smile assessment questions on medical histories:

Is there anything about your smile you would like to change?

Are you happy with the color of your teeth?

Do you have any missing teeth that you would like replaced?

Are you interested in the latest innovations for attaining beautiful teeth?

“Mrs. Jones, you indicated that you are not happy with the color of your teeth. Could I share with you how we might enhance or whiten them?”

Asking patients’ permission to proceed with discussions related to cosmetic dentistry is important. Avoid any inference that patients’ teeth are unattractive.

“Mrs. Jones, Dr. _____ does a procedure called veneers for people who would like to enhance what Mother Nature gave them. Would you be interested in seeing some pictures of her cases?”

If a patient says OK, proceed with the conversation. What are the benefits to the patient?

“The great thing about veneers is that they won’t stain like regular bonding or white fillings ….”

“Having those teeth replaced will improve your ability to chew….”

“Having those missing teeth bridged will allow you to get rid of your partial, which will help your gums. You will be amazed how much more comfortable you will be, and you won’t have to remove it to clean it. It’s almost like having your natural teeth back.”

“You know, I’ve been seeing you now for five years. You’ve certainly come a long way with your oral health since we started. I was wondering why we haven’t done those crowns the doctor recommended some time back.”

If the reason is financial, a response could be, “Well, if there were a way for you to pay over time, would you be interested in learning about that?”

Hopefully, your practice offers extended payments with an outside financing source such as CareCredit®.

Communicating your desires to hygienists

Do you conduct performance evaluations with each staff member? This would be the ideal time to discuss your concerns privately. You can do it in a discreet, nonconfrontational way.

“Sarah, you do fine work here, and I appreciate the care and concern you show our patients. There is one area in which I would like to see improvement, and that is in talking with patients about needed dentistry. Nothing gives me greater pleasure than to hear my staff members promoting what we do here. We have many patients who need dentistry but maybe need just a little encouragement to proceed. How do you feel about discussing elective treatment? Are you reluctant to do that, and if so, can you tell me why?”

Then give the hygienist an opportunity to share concerns. You can’t solve a problem until the problem is exposed. Maybe you need to role play to help each feel more comfortable presenting treatment. Take turns being the patient and the clinician. Possible scenarios could be:

the patient who needs bridgework to replace missing teeth;

the patient with yellowed teeth who could benefit from bleaching;

the patient interested in veneers;

the patient needing full-mouth reconstruction; and

the patient with periodontal disease.

Also, I recommend you track the dollar amount of treatment presented and actually scheduled for each of your hygienists. This gives you and the hygienist a way to measure effectiveness in treatment presentation.

Future hiring decisions should include ­finding friendly candidates who answer open-ended questions with candidness and sincerity.

No one is better suited or in a better position to promote dentistry than you, so do not abdicate that responsibility solely to staff members.

Staff members who happily and enthusiastically promote elective dentistry, however, must be comfortable in doing so, be interested in helping people, possess a thorough understanding of the procedures, and possess the right verbal skills. It is your challenge as the leader to meet all these requirements. You must lead the way.

Best wishes,