Communicating so patients understand

Feb. 1, 2010
In most dental offices, education is viewed as a one–way process, where doctors, team members, and audiovisual programs talk about why problems have occurred and how they can be corrected.

For more on this topic, go to and search using the following key words: communicating with patients, education during examination, Dr. Nate Booth.

In most dental offices, education is viewed as a one–way process, where doctors, team members, and audiovisual programs talk about why problems have occurred and how they can be corrected. I believe that comprehensive case acceptance communication is much more than this. I believe it's a series of conversations where patients accept comprehensive dentistry in several small steps, not one giant leap at a treatment conference.

Here are some times when this communication can occur:

Education before the first visit

The education process begins with your internal marketing, external marketing, and public relations efforts where you educate people about their problems and the solutions you can offer. The process may continue when potential patients view your Web site to view before–and–after photos of your cases.

Education during the taking of records

While taking records, a team member can continue the education process by saying, “Marcy, you told me about a root canal you had done five years ago because of some decay you had under a big, metal filling. I know you don't want this to happen again. So let's take some X–rays to check for decay under those big, metal fillings you still have on your back teeth. Sometimes we can detect decay under the fillings. Sometimes the fillings block our view. Understand?”

Here's another educational conversation you can have during the records process. Let's say Marcy lost a tooth on her upper right side three years ago that wasn't replaced. When your team member takes photos, she can say, “Marcy, I'm going to take photos of your face now. Sometimes when people lose teeth and don't replace them, their cheeks collapse a little bit into the space where the teeth used to be. I want to see how you're doing in the area where you lost a tooth. Does that make sense?”

Education during the examination

1. Don't talk in code while doing the exam and charting. Use language patients understand. As an example do not say, “Tooth No. 2 has an MODBL amalgam on it with a fracture on the distobuccal cusp, some recurrent caries under the restoration on the mesiolingual, and moderate marginal breakdown.”

Do say, “Your upper right second molar has an extremely large metal filling on all five sides of the tooth. The filling must take up 90% of the tooth! I'm really concerned because there is a crack on the cheek side of the tooth toward the back. I also see some decay seeping under the filling on the tongue side of the tooth toward the front. The edges of the filling are crumbling, and my instrument is sticking when I feel the edges. I'm afraid the tooth has some decay under it.”

2. As you do your exam and charting, use emotional phrases such as, “I'm concerned about that huge metal filling on your upper right first molar, Marcy.” Or “I'm worried about the bone loss I see in the areas where you have lost your teeth.” Or “The bleeding around your upper molars is the beginning of a serious problem.” It's vital that you put some punch in your conversation by adding a layer of emotion to your logic.

3. Show and ask. Here's an example, “Marcy, take a look at the photo on the monitor. Do you see the area where you lost that top tooth? Do you see how the bone is melting away from the area as compared with the bone around the teeth that are still there? Take a look at this next photo. Do you see how the tooth in front of the space is beginning to lean backwards? I'm worried that with time you may lose the teeth around the space. That might have happened to your teeth in the back on both sides of your lower jaw. If you're interested, we can show you a great way to take care of the situation.”


In next month's column, I will show you three more ways to add education to your patient conversations. Until then, don't talk to patients, communicate with them.

To receive a free, one–hour DVD of Dr. Booth's Comprehensive Case Acceptance in–office, DVD–based program, send an e–mail to [email protected] or call (800) 917–0008.

Dr. Nate Booth is a speaker, consultant, and author who provides dentists with the information and systems they need to thrive in their dental practices. Dr. Booth is a practice management advisor for ChaseHealthAdvance. He is the creator of the in–office, DVD–based program, The “Yes” System: How to Make It Easy for People to Accept Comprehensive Dentistry. For more information, go to, or call (800) 917–0008.

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