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Selling Home Care

Sept. 1, 2000
Selling professional home-care products to patients has the potential to change the direction of your practice.

Part 2

Selling professional home-care products to patients has the potential to change the direction of your practice.

Bernard Schechter, DDS

During the past five years, I have had telephone conversations with approximately 4,000 dentists on the topic of making oral home-care products available for their patients through their practices. I also have had face-to-face conversations with at least another 4,000 practitioners in exhibitor booths at meetings such as the Greater New York, Chicago Midwinter, Yankee Dental Congress, Hinman, etc.

After 8,000 or so dialogues, one thing is very apparent to me: Making professional home-care products available for patients to purchase at the dental office is here to stay! It is not unprofessional or a conflict of interest, but, rather, a valuable service that can dramatically increase patient compliance. By increasing patient compliance, we positively affect our patients` health, while enhancing the image and profitability of our practice at the same time.

Making home-care products available through the office helps our patients keep their teeth for a lifetime and enjoy the systemic benefits that accompanies a healthy dentition. Proper home-care techniques and products are essential to this goal. In the process of providing this service to our patients, we increase practice revenue.

Product selection

Until recently, the general trend has been that the type of practice a dentist has influences what products he or she makes available to patients. Practices that emphasize cosmetic services sell lots of home-bleaching kits. Those with large proportions of caries-prone patients (children and the elderly) tend to carry fluoride-therapy products containing either Neutral Sodium Fluoride (NSF) or Acidulated Phosphate Fluoride (APF). Practices with soft-tissue management programs focus on periodontal products, such as antimicrobial rinses, subgingival irrigating solutions, mechanical irrigators, interdental brushes, and power toothbrushes.

Marketing home-care products that complement the focus of your practice is the natural thing to do. However, think about this for a moment: in addition to enhancing the services you already offer, you can use in-office product sales to expand or even change the direction of your practice.

For example, with today`s concept that whiter teeth look better than darker ones, even mis-shapen or malposed teeth look better to most patients when they are made a few shades lighter. Successful use of home-bleaching kits often leads to more patient requests for cosmetic bonding and veneers. The availability of high-quality periodontal and antihalitosis products encourages patients to return regularly for their recall appointments, sometimes just so they can purchase the rinse, toothpaste, or spray that is only available through their dentist.

Patients who are borderline periodontal-surgery candidates often are resistant to the surgical phase of therapy, either because they are financially unable or emotionally unwilling to undergo the surgeon`s knife. Many of these patients also need thousands of dollars of cosmetic and restorative dentistry. If the periodontal structures are questionable and the patient is unwilling to undergo surgery, the dentistry often does not get done.

Resolving periodontal conditions with in-office, deep scalings and providing high-quality home-care products (with proper instructions on how to use them) gives patients a sense that all is not lost just because they have refused the surgical route. They learn that they can help themselves at home, and thus form a partnership of shared responsibility for their periodontal health with their dentist and the dental team. Frequently, this leads to patients to decide to complete the cosmetic or restorative dentistry they need, resulting in a true win/win situation.

Office displays

You can set up a display for the products in several different areas of your office. Suitable areas include the waiting room, hygiene room, operatory, business office, and even the dentist`s private office. The size, style, and location of the display area(s) will vary with the individual office design and practice philosophy.

For example, Dr. Tom Orent has a product display covering an entire wall in the hygiene room, as well as a substantial display in the reception area. Many companies have countertop displays which can be tastefully utilized. If multiple product lines are sold through the office, a space problem could arise using manufacturer`s displays. In this instance, removing products from the display and placing them on a shelf or countertop may be the answer.

A little creativity can go a long way here. Some offices do not display products, but have a rack of various product brochures in the reception area. Patients can browse through these brochures while waiting for their appointments, or before they leave the office. Then, they can ask to see a product that interests them or a product that has been recommended to them.

The key is to present the products in such a way that patients realize you are making them available because you truly care about their dental health.

Direct mail or newsletters

Many offices have a bimonthly or quarterly newsletter that they send to their active patients. This is an excellent vehicle to make patients aware that home-care products will be available through your office. A brief description of the products and why you feel they are beneficial will serve to establish or reinforce in the patient`s mind that his or her dentist is on the "cutting edge" of modern dentistry.

Reactivating inactive patients

I have recommended this technique to many dentists and have received some very positive feedback that this method really works. Make a list of all formerly active patients that you have not seen for the past three or four years, but who have never requested their records be sent to another office. Many of these people are not dissatisfied with your services, but had other reasons for not showing up during that time. They may still be your patients, but might need a little push to realize it!

Send them a letter describing your new or expanded services relative to home-care products available through your practice. Let them know about the effective professional-strength periodontal rinses or antihalitosis formulations that compliment your professional treatments. Tell them about the possibilities of having lighter, more attractive teeth, using the safe, custom trays and effective ingredients in the home-bleaching kits your office provides. Emphasize that they cannot buy these same products in retail outlets or pharmacies. Invite them back to the practice - you may discover that they were just too embarrassed to call for an appointment after such a long absence. The appeal of innovative home-care products - only obtainable through your office - might be just the impetus they need to pick up the phone and make that call.

Patient education vs. selling

A number of new dental products have been introduced into the market, with many manufacturers attempting to bypass clinicians and go directly to the public via a blitz of media advertising. Patients see these ads and become confused about which products might really benefit them. They arrive at their appointments with many questions about which home-care products they should use.

Make professional home-care products a topic of discussion at a staff meeting. It is fairly easy for the dentist and staff to garner some basic knowledge for themselves in this area. Then, when your patients ask questions about home-care products, you`ll have the answers.

Additional education in the form of instruction and demonstration of correct product use and home-care techniques is invaluable to the patient. It raises the level of our service and gives the patient more respect and confidence in the practice. The time spent on this instruction establishes or reinforces the patient`s feelings that staff members want to deliver the highest quality of care. Demonstrating the proper use of professional home-bleaching kits sets these products apart from the $39.95 home bleaching "specials" sold in stores or on TV. Making sure that the patient understands how to use mechanical irrigators and subgingival irrigating solutions, power toothbrushes, interdental brushes and applicators, tongue cleaners, professional-strength anti-microbial rinses and gels, or professional-strength fluoride-therapy products differentiates these items from over-the-counter products.

The end result of this focus on patient education is that the products sell themselves. The patient purchases the appropriate products at the office and can return home to begin using them that same day. They don`t have a feeling that they were "sold" anything. They were given information at their dentist`s office about how they could help maintain the excellent results already achieved through professional treatment. They feel fortunate to be able to obtain the right products for their needs, without having to make another stop at the supermarket or pharmacy.

Role of the hygienist

Since a substantial percentage of in-office products are for establishing and maintaining good periodontal health, hygienists are in a very unique position to observe the clinical results. The hygienist usually is most responsible for home-care instruction and, therefore, best situated to discuss the clinical benefits and costs of products with the patient. If a particular periodontal or halitosis product (these conditions are often related) works well, the hygienist will see the clinical results, be able to communicate these results to the dentist and other staff members, and recommend the formulations to patients.

Allowing the hygienist the freedom to order a new product - or to request that you do - can lead to very positive results for both the patient`s health and the practice`s bottom line.

Role of other staff members

Depending upon their level of motivation and capability, other staff members can participate and be a positive part of an in-office product program. Frequently, the chairside assistant is left alone with a patient when the dentist leaves the operatory for a few minutes to administer anesthesia, check a recall, or take a phone call. Patients often use this time to ask the assistant about home-care products available through the office.

In another situation, the front-desk person might engage in a conversation with patients who have read brochures in the reception area or who are purchasing products recommended by the hygienist or dentist.

To profit or not to profit

That is the question. Many dentists have asked themselves if it is ethical to sell home-care products through the practice, and many dentists are still indecisive about whether this is something they should do. The answer is that most offices that make products available for patient purchase do so at a profit. Manufacturers usually have a suggested retail price or price range. As a general rule of thumb, the suggested retail is anywhere from "net 40 percent" to "net 50 percent." This means if a practice purchases a product for $15 per unit, the suggested retail is anywhere from $25 to $30 each.

My company recently conducted a mini-survey on home-care product pricing. We contacted 100 dental offices that sell products to patients and asked them what they charged for the products. Eighty-eight offices charged the suggested retail price, seven charged more than the suggested retail, and five charged less.

Some dental offices sell products to patients at cost or slightly above cost. If this makes the dentist feel better, I can support this approach because it helps the patient obtain high-quality products at below-market prices.

Many dental offices build the cost of an initial supply of products into their treatment programs. I know several top-notch restorative and cosmetic practitioners with comprehensive, nonsurgical periodontal programs in place. Patients travel long distances to see these dentists and their hygienists. Treatment usually includes six or seven hours with the hygienist for periodontal deep-scalings and a lot of instruction on home-care techniques. The treatment-program fee also may include a mechanical irrigator, a two-month supply of subgingival irrigating solution, a power toothbrush, and possibly a toothpaste, an interproximal brush or applicator, and a two-month supply of an antimicrobial rinse. The cost of these mechanical and consumable supplies - including profit from their sale - is built into the total fee.

The bottom line

So what is the bottom line? How much revenue and profit can a practice generate from in-office sales of high-quality products? Obviously, it will vary considerably, based upon the size of the practice and the attitudes of the dentist and staff. What follows is a conservative estimate of the upside potential. The figures do not include sales of mechanical irrigators and power toothbrushes, nor do they include the revenues generated from complete home-whitening kits. Those items would bring the following estimates to much higher numbers.

For the sake of our example, let?s say that you have 300 patients using such consumable products as antimicrobial rinses, irrigating solutions and toothpastes, refills for home-bleaching kits, fluoride-therapy gels, foams or pastes, and anti-halitosis products. Suppose each patient was spending an average of $30 per month on these products (a conservative figure).

As mentioned earlier, patients often buy enough products at their recall appointment to last until the next office visit. That would come to a total of $9,000 per month or $108,000 per year of gross revenues for these 300 patients. At net 40 percent to 50 percent, your profit would range from $43,000 to $54,000 per year. That is a substantial amount of money, and it is a conservative estimate of what can happen. Most dentists would love to earn an additional $50,000 per year helping their patients ? not to mention doing it without picking up a handpiece! If your goal is to create a serious profit center for the sale of in-office products in your practice, this profit figure could be a good deal higher.

So Oto profit or not to profitO is no longer the question. The question should be, OHow much can you profit?O The answer is: It?s up to you! Product sales is a wonderful way to raise the level of your services to your patient and to help your staff if you choose to share some of the profits. It also is a wonderful way to help yourself and your family by increasing your income and raising your economic standard of living. It is what you deserve as a dental practitioner who contributes to the health and well-being of your patient.

Will your patients buy home-care

products from you? Ask them!

Research has shown that approximately 90 percent of halitosis originates in the mouth. Estimates indicate that 25 to 80 million Americans suffer from bad breath.

Consider doing an in-office survey composed of two questions. The easiest way to do this would be to add the questions to the patient health-history form. The questions are:

(1) "Have you ever been told or do you feel that you have bad breath?"

(2) "If so, would you like professional help to treat this problem?"

You might be surprised at the large number of patients who would respond to these questions by asking for your help.

The amount of money spent on antihalitosis products in the United States is approaching $1 billion annually! Nearly every manufacturer has a study (often designed and paid for by the manufacturer!) showing that its product is the best one on the market, superior to all the others. Who is the patient to believe? Who is the dentist to believe?

The most comprehensive and unbiased study to date is the ongoing fresh-breath study being conducted by Clinical Research Associates of Provo, Utah. CRA`s Web site - - reports the results. Check it out.

Click here to enlarge image

Dr. Tom Orent discusses home-care products with a patient.

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