10 tips to make quadrant dentistry faster, better, and easier

by Dr. Joe Blaes, Editor

At a series of meetings, our team decided to make a contract with our patients that embodied the philosophy and mission of our practice. Each patient was told, “We will help you keep your teeth for the rest of your life.” This led us to improve everything we did relative to patient care, and focus on providing the best possible treatment individually designed for each patient.

One of the first areas we looked at was our restorative procedures. At that time, we often gave in to a patient request to patch a tooth to make it last longer. When we finally had to do a crown on the tooth, we only did that one, even though the adjoining teeth needed to be restored as well. This was no way to help our patients keep their teeth for the rest of their lives.

The team acknowledged that quadrant dentistry was a better treatment for patients. Quadrant dentistry would give them better contacts, better occlusion, better shade matches, and better tissue response. Quadrant dentistry would make patient maintenance much easier and help patients keep periodontal disease under control. Our decision was to make quadrant dentistry our treatment of choice! Now everyone was on the same page and enthusiastically supported the decision. This cannot be a unilateral decision by the doctor. The team must “buy in” because you cannot do this alone.

Tip 1. Your team must agree and enthusiastically accept that quadrant dentistry is the best treatment for your patients. I believe we should tell our patients what is the best and let them judge what they want. Patients often rely on your team members to help make decisions. Train your team on the benefits of quadrant dentistry so that they can “sell the sizzle, not the steak.”

Tip 2. It all starts with the new-patient exam. Give new patients a WOW experience by asking them what they expect from your office. I think you will be surprised by the answers. “First, seek to understand.” Ask lots of questions. Answer questions with a question. Get as much information as you possibly can. In my office, this new-patient “interview” is done by a dental assistant, a hygienist, or a patient coordinator. When you have all the information from your patient, then “seek to be understood.” Now is the time to tell the story of how your office is unique.

Tip 3. When you present your treatment plan to patients, tell them the whole story. Be sure you relate to concerns that the patient has shared with you. Treat this patient as you would one of your family members. Please do not make the mistake that I made for many years - trying to sell crowns, inlays, and bridges. Instead, sell the benefits of excellent dentistry to your patients. Show them how they can afford this treatment with help from CareCredit. If they cannot start now, I treat the teeth that are in need and place long-lasting temporary restorations. This way, I can keep these patients in a “holding program” until they can start their permanent treatment. I do not want any patients leaving my practice.

Tip 4. We analyzed our procedures to better understand our costs in producing a quadrant of dentistry. We found that it took much less time and material to do quadrant dentistry, so we give our patients a 15 percent discount on our single-unit fees. This often is the “push” that patients need to get started. Remember - we are selling service, not pieces.

Tip 5. We found that in many instances, we could do quadrants in a sequence. We start with the worst quadrant and go on from there. We have established what I call a “quadrant bank.” At our morning huddle, the hygienist will remind me that Mary Smith is coming in today and it is time to start on her next quadrant. The hygienist and I will both reinforce the need to treat the next quadrant.

Tip 6. The demographic group called “baby boomers” was treated with many amalgam restorations, which are now in various stages of breakdown. This is a great group on which to begin your quadrant dentistry. In general, they are interested in keeping their teeth. They want to look good and feel good! As Dr. Nate Booth states in his article, talk to them about avoiding future problems by treating now (page 46). Your patients will want to know the benefits of reduced visits, injections, emergencies, time in the chair, and better dental health. I consider the anterior teeth as a quadrant in case the patient wants his or her smile restored.

Tip 7. In the treatment room, be sure to give your patient a WOW experience - don’t hurt them! Do whatever you need to do to eliminate anxiety for your patient by making this a comfortable experience. If you fail here, you probably will only do one quadrant on the patient. Use a rubber dam or the new Isolite System so you can see what you’re doing and keep all of the old amalgam scrap out of the patient’s mouth.

Tip 8. Dr. Omer Reed always told me I was a “file cabinet millionaire.” I never understood this until I began doing quadrant dentistry. Your patient records are full of undone dentistry! I expect my hygienists to help my patients understand the need to treat this undone dentistry. These are the patients who have slipped through the cracks in your system. My hygienists will not do a root planing and scaling in the presence of subgingival amalgam overhangs. I depend on my hygienists to refer to me 35 percent of what I produce in my treatment room. They are very enthusiastic about quadrant dentistry because they have seen the results in improved dental health.

Tip 9. With quadrant dentistry, your clinical treatment becomes much more efficient. You will find that you have longer appointments and that you are not jumping from chair to chair. You will enjoy dentistry more. You will have more time to spend with your patients and will actually get to know them better.

Tip 10. From an economic standpoint, you will see your hourly production increase significantly when doing quadrant dentistry. I now have the security of many patients in our “quadrant bank,” awaiting future treatment. This is how I can produce more dentistry with less stress. I hope you will read both “Focus On” articles in this issue and begin treating quadrants in your practice.