Attention to detail is one attribute that separates good dentists from great ones: the kind who have patients so satisfied that they stick around for a decade or longer even when they move or change insurance providers. My experience using microscopes over the past 15 years shows that video is an ideal way to achieve that attention to detail.
Some dentists use microscopes to achieve magnification 5 times greater than alternatives such as loupes. Others use intraoral cameras or digital single-lens reflex (SLR) cameras. These devices enable them to capture video, which then can be fed to the displays that many exam rooms already have.
Videos are ideal for conveying information to patients. They can be paused and rewound when patients have questions. They also can be viewed in real time during exams and procedures and are easily saved to an USB drive so patients can show family members why they need treatment and/or the importance of good hygiene.
Also, archiving is useful for showing patients certain aspects of how their oral health has improved over time. For example, before-and-after videos are superior to x-rays when it comes to showing how treatment has made their bite more symmetrical.
The new-patient exam is a critical time to use video because it makes it much easier for the dentist to show, and for the patient to understand:
- The need for treatment: New patients typically assume they need only a cleaning, so they’re surprised when they hear that they have, for instance, loose or cracked teeth. That surprise is understandable when those conditions haven’t advanced to the point that patients notice. Video is highly effective for convincing patients that these conditions exist and need to be treated before they advance to the point that requires expensive, extensive work—or the worst-case scenario of tooth loss. X-rays are an obvious alternative, but they’re much more difficult for the untrained eye to comprehend, leaving patients confused or skeptical. X-rays also are snapshots, so they can’t show, perhaps, a tooth that’s moving so slightly that patients don’t feel it.
- Treatment options and procedures: Some new patients are presented with conditions that can be treated in multiple ways. For example, one of my new patients had cracks on both sides of a filling, suggesting that the filling was failing. Video helped her understand that removing the filling could reveal that the crack spans the entire molar, requiring a crown to save it. She had already lost her lower, second molars, so the crown enabled her to keep this one.
- Dynamic relationships: Many patients don’t realize that they have a malocclusion, for instance, nor do they believe it when they’re told. But they do when the video clearly shows how that their teeth aren’t all hitting at the same time.
- The need for better oral hygiene practices: Showing patients a video of their mouth helps them better understand how their oral hygiene habits directly affect the amount of plaque and decay that is present in their mouths. When patients can see the places they are missing or the areas they are over-brushing, it empowers them to know how to do a better job in their oral health regimen. For example, one of my patients flosses too aggressively, perhaps because she’s a nurse and thus understands the relationship between oral hygiene and conditions such as heart disease. As a new patient, she was presented with several 2- to 3-mm cuts. Now that she understands proper flossing techniques, those cuts have healed, but they’ve left areas where food and plaque can build up. This situation might have been avoided if a previous dentist had used video to show her the effects of aggressive flossing when they first became apparent.
Maximizing Efficiency and Efficacy
Dentists who don’t currently use video but are considering it usually have questions about how much time is involved. For a new patient, I typically spend 10 minutes recording the video and then an average of about 10 minutes explaining it and answering questions.
People often are surprised when they’re told their initial exam will take an hour, when their previous dentists required only 15 minutes or so for new patients. This surprise can be beneficial for the dentist because it shows the patient how thorough that practice is—in other words, a competitive differentiator.
Dentists are sometimes concerned about whether an hour is too long, especially if a patient’s insurance provider limits the amount of reimbursement for an initial exam. That’s understandable, but I recommend looking at the big picture. The more satisfied new patients are, the more likely they are to remain with that practice.
One patient testimonial speaks directly to this principle. The patient first came to me in 2002, and since then, I’ve replaced one of his previous crowns, as well as a tooth that had internal resorption with an implant and crown. In the testimonial, he discusses how the use of the microscope and video gave him a better visual and understanding of his dental issues, and it clarified why certain procedures needed to be done. With a clearer knowledge of the situation, he has developed a trust in my practice and continues to see improvements in his dental health.
High loyalty saves money because that practice now spends less on marketing and incentives to replace patients who move on. Satisfied patients also often share their experiences with friends, family, and colleagues, driving additional patients to that practice.
A thorough video created during the new-patient example can also enable hygienists to offer highly personalized care in subsequent appointments. Doing so frees the dentist to work with other patients who require more extensive care, such as root canals and fillings. This is an example of how video can enable a practice to work more efficiently.
Finally, when considering whether to add video to their practice, dentists should ask themselves what they want each patient to remember: the number of crowns, fillings, and implants they’ve received, or the number of healthy teeth they have? My experiences show that video makes it significantly easier for dentists and patients to work together to achieve the latter.
Dr. Craig S. Kohler, DDS, MBA, MAGD, has been practicing on the North Shore of Chicago for more than 30 years. After completing his residency, he earned his Fellowship and master’s from the Academy of General Dentistry by completing 1,600 hours of continued education, an award that less than 1% of the dentists in the nation earn. He also mentors at Evanston Hospital and at the Spears Institute in Scottsdale, Ariz.
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