Jump—Start Case Acceptance Through Your Hygiene Department: R-E-A-C-H for Success

Dentistry Today


Dental offices around the country are again beginning to feel the effects of Reality TV, and that’s not such a bad thing! As the new hit TV series “Extreme Makeovers” is renewed for a second season, it seems that viewers of all ages are continuing to be captivated by the makeover possibilities that can change their appearance, their smiles, and their very lives! New techniques in modern medicine seemingly now make all things possible.

Both men and women are taking advantage of all the medical world has to offer, and in the process, they are enduring the dangers of general anesthesia, the pain of recuperation, and the hours of lost work and pay involved in looking the best they can look. A visit to the Web site of the American Academy of Plastic Surgeons will show you how many cosmetic procedures of varying degrees are performed annually. 
The amount of discretionary dollars spent in search of the perfect self is mind-boggling. With the look of success, people feel they can actually be successful. Where is the dental community in this process? We know that simply whitening a smile makes patients look (and feel) 10 years younger! 
The reality is, it is up to us to get the word out when it comes to the possibilities of today’s dentistry. A generation ago, orthodontics was the basic cosmetic dental procedure performed on adolescents, yet today it is only the tip of the cosmetic iceberg. How many of our patients now realize that invisible braces and clear brackets have replaced metal brackets and that veneers may be a quicker solution to minor alignment issues? When did whitening become a procedure that all age groups enjoy? Are we afraid to mention it to our elderly patients because we feel they are too old to understand it or to enjoy looking younger? 
If you were to add a question to your registration form asking if patients are happy with their smile or the color or alignment of their teeth, you may be surprised at the answers you receive. Furthermore, if your hygienist is the first person to ask new patients about their answers, you may find that patients respond more quickly than if you, the doctor, mention new procedures. 
Surprising to all of us, however, is the reality of just how little our patients know about the services we offer. Why is that? Could it be that we often feel “rushed” (eg, fix teeth, fill teeth, clean teeth, provide excellence of care, complete a thorough periodontal screening, implement HIPAA, review chart documentation, schedule the next appointment, wait on hygiene checks, do hygiene checks, secure financial arrangements, manage the staff, manage the business)? You name it, and by day’s end most of us are running on empty. At the end of our vicious and self-imposed cycles, we’re spent. With little or no time to talk about anything beyond the most obvious and immediate treatment possibilities such as broken teeth, abscessed teeth, or missing teeth, it is only upon reflection—usually in the “rear view mirror”—that we recognize what could have been said or perhaps should have been said regarding alternative and cosmetic procedures.
As we lead our busy lives and manage our growing practices while juggling to take good care of our patients, do we literally have opportunities slipping through our fingers? Sure we do. Most of us are working too hard and too long to make things happen in dentistry. Many times, immediate need takes precedence over a full and comprehensive treatment plan, which, when completed, returns the patient to a healthy periodontium and occlusion. Missed opportunities should lead you to discuss with your staff how to take advantage of patients’ interest in looking and feeling better and how to “jump-start” your case acceptance.
Possibilities existing in today’s dental practices are more exciting than ever before! With national trends showing an aging population living longer, people more in touch with health and nutrition, and media attention focusing on lifestyle changes and extreme cosmetic makeovers, the future for dentistry couldn’t be brighter! However, if we’re already running on empty with case acceptance, or slowed to a standstill, we could find ourselves in need of a case acceptance jump-start.

We’ve all had the experience of jump-starting an automobile at the most inopportune time, right? Think about it. You have a dead battery in your car. You want to know what caused it and how to fix it. The 3 biggest causes of a dead battery in a car are (1) leaving your lights on; (2) failing to maintain your battery properly; and (3) breakdown of the voltage regulator to your alternator.

Let’s apply this dead-battery analogy to increasing case acceptance through your dental hygiene department.


For Doctors Only
Leaving your lights on. Don’t “leave your lights on” in the hygiene department! Using the battery analogy, you rush to your car to find that you’ve left your lights on from the night before. Chances are you were preoccupied, rushing, or simply too overwhelmed by the day’s activities to pay attention to the light switch.

Running on auto-pilot has the same result no matter when or where it occurs. Without conscious thought and running on the hope that your routine will continue to save you from making mistakes, the same thing can happen to your relationship with your hygiene department that can happen to your car battery. Don’t be so preoccupied with your practice that you fail to take the time to communicate with your hygiene staff. Rushing through your day avoiding hygiene checks or being overwhelmed by the fact that your hygienist has already beeped you 3 times only reduces your chances for success. 
Proper maintenance. Maintain your dental hygiene department properly and remember to check in often. Make it a priority to hire and maintain skilled staff in your hygiene department. As a whole, today’s dental hygienists are more informed, better skilled, and clinically more aware of possibilities to promote case acceptance than ever before. That being true, ask yourself how much time you have allowed to provide your hygiene department with the tools they need to jump-start case acceptance. Check in often and know what is going on in your practice. When was the last time you took the opportunity to schedule a meeting with your hygiene department and really listened to what they had to say? How long has it been since you’ve talked about ways to improve case acceptance? Have you checked to see what courses are available that would help give your hygienists the tools they need to be successful and to promote the dentistry your patients need and want and that you enjoy doing?
Avoid breakdowns. Avoid breakdowns in case acceptance by exhibiting excitement and passion! Just as the voltage regulator in your car provides the surge needed to start your engine, your hygiene department needs your excitement to succeed. For example, if the alternator in your engine is producing 12 volts (instead of its normal 14 volts), this will be insufficient to charge the battery. Result: dead battery. Similarly, if the bulb is blown, the alternator will not have any initial excitation and may never “cut in” and start charging. Result: dead battery! The same is true for your hygiene department staffers. If you are not excited, why should they be? If you are not passionate about the possibilities you can provide to change patients’ lives, why should they be? Give your hygiene department staffers the opportunity to experience your initial excitation about jump-starting case acceptance. You may be surprised at how they “cut in” and start charging!

For Hygienists Only
How can we design a program to jump-start case acceptance through the hygiene department? Could it be that in­creased case acceptance is simply ours for the asking? If so, reaching for success requires a plan. Begin by implementing these 5 steps of R-E-A-C-H to jump-start case acceptance within your own department:

1. Research your patients’ needs and wants. You see them frequently and can follow their progress and health. Spend time identifying and reinforcing their good habits and building toward reasonable goals. At each appointment, reinforce their original and stated personal goals. Do they want whiter teeth, healthier gums, a better and more appealing smile, and teeth that are in perfect alignment? The more often their goals are identified and reinforced, the more likely they will trust your judgment and value the relationship they have built with you.
Building trust and confidence takes time, and you have the time and the skills to make an average patient a terrific pa­tient. Spend your hygiene ap­pointments connecting with the patients and building rapport. Patients can get their teeth cleaned anywhere, but they choose to come and see you. Reinforce the connection. When they are ready for advanced dentistry, they will let you know! 
2. Educate your patients about what is available in dentistry today and how easily their goals can be obtained. Evaluate their goals in light of their expectations and establish their trust by being truthful about expectations and reality. How white do they want their teeth to be and what is actually possible? Will the veneers actually give them the smile they want? Do they enjoy the diastema that sets them apart from others, or would they feel better with a “perfect” smile? Many times, surgical cosmetic procedures fail not because of technique or skill but because the patient did not know the reality of his or her case. 
Review the emotional motivators of patients. Peel the proverbial onion and listen. Make sure they feel that they’ve been heard. Educate them about the opportunity to take care of their immediate needs and use technology to show them via computer imaging what can be done to reconstruct their mouth and change their smile. Effectively use the time you have while waiting for the doctor’s exam to probe deeper regarding their needs and wants and show them what is possible and how easy it is for them to obtain it. The gain for them may be as simple as an improved self-image or as wonderful as a different personality and a successful career. 
3. Assess. Ask patients for their permission to take photos of their teeth and gums. Involve them in your game plan to improve their smile. Ask them what they see and what they think they’d like to do about it. Take small steps and give them permission to move slowly, all the while building toward a common goal. When a complete treatment plan is identified and agreed upon, it is easy to chart patient progress. Missed opportunities do not occur because you took the time to be complete at the beginning. Cracked teeth, fractured amalgams, missing teeth, and collapsing occlusion have all been built into the plan. Charting the periodontal health at regular intervals gives you a chance to evaluate patient home care and build on a solid foundation. 
Assessing not only patients’ dental health but also their overall health is an opportunity for you to see if they really are living up to expectations. Are they nutritionally aware? Is their diet indicative of overall wellness? Are they aware of the links between periodontal health and heart disease, low-birthweight babies, oral cancer, and tobacco habits? Cosmetic dentistry may not be indicated in a patient with risk factors. 
4. Celebrate success with patients when it occurs and in whatever form it takes! You have built a solid relationship over time, and they will want to share their good fortune with you. After all, you helped them reach their goal. They want you to be proud of their achievement. Most people are happy when sharing good news with others. Continue to communicate with them in positive ways. If their interim goal was small, it still deserves a round of applause. Perhaps it was a tobacco habit they eliminated or maybe they simply learned to floss daily! Imagine the possibilities you have at your disposal to improve another’s life. Work with the doctor and other staff to share joy at each appointment. Celebrate the work your patients are trying to do and your part in it!
5. Honor the trust that you build with your patients. Be helpful and honest in your dealings with both your patients and your doctor. Support the goals of the practice to bring health and wellness to all of your patients. Help the doctor to remain excited about dentistry. Instill the spark and ignite the fuel to keep your career glowing and the practice strong.

The dental practice is just like an engine; it takes the right mix of fuel, spark, and excitation to jump-start an automobile and just as much to invigorate and increase case acceptance. Start now, stay excited, stay involved, and save fuel for the difficult days ahead. And remember to R-E-A-C-H for success.

Ms. Hunter is senior management consultant and vice president of the Reach Institute, Celebration, Fla. She can be reached at anh@mindspring.com.