The new-patient exam: the dental assistant's role in developing trust

Oct. 20, 2009
Dr. Rhonda Savage explains how important the dental assistant is in developing relationships with patients.

By Rhonda R. Savage, DDS

New patients come to you with varying degrees of trust. A patient referred by another patient will come with a much higher level of trust. A patient generated by way of outside marketing will be a bit more skeptical and hesitant. Regardless of how you obtain a new patient, you’ll need to “hit it out of the park” with her new-patient experience to get her to come back. You not only want her to come back, you want her to refer friends, family, and co-workers.

Why the female reference? Worldwide, women tend to make the health-care decisions for the family. According to the Boston Consulting Group, women control $12 trillion of the world’s $18.4 trillion in annual consumer spending, and they tend to spend more on things linked to a person’s well being, such as health and education.

Whether male or female, new patients come to your office expecting that you have the skills and training to take care of their dental needs. For new patients to believe and trust in your office, skill development for every team member is crucial, especially for the dental assistant.

Dental assistants are highly capable and quite talented at engendering trust with new patients. Research has shown that case acceptance is higher when the new patient is scheduled first in the doctor’s chair, with the dental assistant, rather than in the hygiene chair. This is due to five reasons:

  • First, the doctor tends to spend more time with new patients if they are scheduled in the doctor’s chair prior to hygiene.
  • Second, the dental assistant can spend quality time with the patient, freeing up the hygienist to use his or her talents in providing hygiene care and education about periodontal disease.
  • Third, the appropriate amount of hygiene time can be determined in advance; fee estimates can be given accurately and the proper treatment can be scheduled.
  • Fourth, if a new patient were to fail the initial appointment, the impact on the valuable hygiene time is minimized.
  • Fifth, it makes sense financially to use the talents of an assistant with regard to data gathering, taking initial X-rays, and utilizing the intraoral camera.

A question for your dental office: “Legally, what can a dental assistant do in your state?” One thing is true: regardless of state law, dental assistants can talk and write. With proper training, dental assistants are true assets to the team and patient care. The more the dental assistant can speak for the doctor, the more time the doctor can have a drill in his or her hands.

Let’s begin by connecting with the patient. A connection is more than “Hi, how are you? I’m Amy, Dr. King’s assistant.” A connection is common ground. It could be about school, children, family, sports, art, or music ... anything that helps you connect. New patients need three connections prior to you tipping them back for X-rays. As an aside, the returning recall patient needs two connections by the hygienist. The patient who comes in frequently needs one connection. Here’s another secret: the dentist also needs to take the time to make a connection.

The great thing is that the dental assistant can begin the process and make the dentist’s job easier. Let’s review the ways the dental assistant can help with the new-patient exam.

He or she can ...

  • Connect with the patient
  • Review the health history
  • Ask about the patient’s chief concern
  • Take the necessary X-rays, provided your state allows this. To find out what your state allows in radiography, click here to visit DANB's state-specific information.
  • Chart existing restorations
  • Note missing, crowded, rotated, or yellow teeth
  • Take an initial blood pressure screening
  • Set the stage for case acceptance by asking questions like:
  1. “It looks like you’re packing food between these two old fillings. Has that been a problem for you?”
  2. “Have you ever considered whitening your teeth?”
  3. “If there was one thing you’d change about your smile, what would it be?”
  4. “Has anyone talked with you about the importance of replacing this missing tooth?”
  5. “Your gums look puffy and irritated. Do they bleed when you brush?”

In addition to this, the assistant can do an intraoral camera tour of the mouth. Have four to five pictures up prior to the doctor stepping into the operatory.

Do you have intraoral cameras in your office? On a scale of 1 to10, what is the use? Most offices rank their use as 2 to 3. On a scale of 1 to 10, you should be using the intraoral camera on a level of 7 to 9. The intraoral camera is one of the best educational tools available to the dental team.

How does the dental assistant receive training in these areas? First, consider the assistant’s speaking ability. Is he or she shy or quiet? Is speaking to the patient difficult? The assistant might consider some speaking classes. Truly, the ability of the assistant to speak well and write legibly will determine his or her income level. Those who can write better and speak well will earn more money.

I found a solution to shyness. I grew up quite shy. I started in dentistry as an assistant, and trained “on the job” as an assistant in the little town of Ketchikan, Alaska. I know personally that through hard work and dedication, one can make dentistry a career! I joined Toastmasters, an internationally known organization that helped me become a better speaker. I don’t necessarily mean that everyone has to give speeches. Toastmasters simply helped me become a better speaker one-on-one with my patients. It’s a very affordable organization. You can Google Toastmasters International to find clubs in your area. It’s important to visit several clubs before deciding on one. I also took English classes at my community college. I pushed myself outside my comfort zone.

If you’re learning and growing, you should feel somewhat uncomfortable. If you’re comfortable with what you’re doing, you’re not challenging yourself. The beauty of dentistry is that there’s always more to learn and do, and you should never feel comfortable! Dentistry is truly a career, and you can make of it what you put into it.

Another way for you to learn these skills is verbal cue cards. These are where you write down every question patients ask you for one week. At the end of the week, summarize the list. Then ask your dentist to write down his or her answers in only two to three sentences. Put the questions on one side of a 5x7 card and the answers on the other. Then — practice! Ask a friend to help by quizzing you. Soon you’ll be saying what the doctor wants you to say. Don’t memorize the cards; internalize them in your own words.

Do this same exercise for the most common procedures in your practice. Ask your doctor to write down the two benefits for every procedure and two consequences if the work isn’t done.

Practice writing up charts. Ask your doctor to review the chart entries every night and give you feedback on what needs to be changed. The secret is that you must make the chart changes. If the doctor makes the changes, you won’t learn what he or she wants you to write.

You’ll need training by your doctor to be able to accurately write down the existing restoration. You’ll also need training to use the intraoral camera. I would recommend you ask your doctor to set aside time each month for training and also to use down time for training.

As a dental assistant, you are an amazing person with tremendous potential. Don’t ever sell yourself short on the incredible difference you can make every day in your patient’s life! Stretch to the point of discomfort; continually learn and challenge yourself. Dental assisting is not “just a job” ... it is truly a career!

Author bio
Rhonda Savage, DDS, has been in private practice for 16 years, and is the CEO for Linda L. Miles and Associates, an internationally known practice management and consulting business. Dr. Savage is a noted speaker who lectures on practice management, esthetic dentistry, women’s health issues, periodontal disease, communication and marketing, and zoo dentistry. You may reach Dr. Savage at [email protected].