The pursuit of distinction

Cosmetic dentistry has moved into the mainstream of private dental practice. More and more dentists are learning cosmetic techniques, participating in exceptional study clubs and purchasing new technology. They are eager to provide esthetic treatment to their patients.

Dental practices expanding into cosmetic dentistry must make their services distinctive.

Ross W. Nash, DDS and

Debra Engelhardt-Nash

Cosmetic dentistry has moved into the mainstream of private dental practice. More and more dentists are learning cosmetic techniques, participating in exceptional study clubs and purchasing new technology. They are eager to provide esthetic treatment to their patients.

Advances in technology, materials and techniques have created esthetic materials that rival or surpass conventional treatment. These advances have improved the ability to restore and maintain periodontal health. As a result, more patients have begun to demand esthetic dental treatment.

Insurance exceptions, philosophy of diagnosis and time constraints often inhibit general practitioners from performing this type of dentistry as often as they would like. Building this type of dentistry into the general practice requires team understanding and support, presentation skills and developing methods to attract patients to the esthetic segment of dental care.

The dental practice that wants to expand its services to more esthetic and cosmetic care must find ways to visibly differentiate its services. It`s time to do more than find out what patients need. We need to ask them what they want.

Esthetic and cosmetic procedures in modern dental practices are providing increased job satisfaction for both dentist and staff. They can add higher productivity in this age of better overall dental health.

Know Your Market

For many years, our practice has focused its efforts on developing a dental environment that caters to patients who understand and appreciate dental esthetics in necessary procedures, as well as patients who desire elective, cosmetic dental treatments. This past year has proved to be our best year ever. Our productivity has increased over 70 percent from last year-our previous record year.

We all know the patient population is aging. People over 50 are in control of 70 percent of the discretionary income in the United States. Fifty-five percent of children and adolescents between the ages of 8 to 15 have no caries or decay in permanent teeth. The use of sealants has doubled in 10 years.

The average adult has 60 percent decayed, missing or restored surfaces. Twenty-five percent of employed adults have severe periodontitis, and only 25 percent of our population between the ages of 8 and 50 have perfect alignment of front teeth.

The statistics clearly indicate the potential for expanding dental services to include new areas of fee-for-service, necessary and elective treatment. The most common problem in most dental offices is the failure to diagnose or present esthetic/cosmetic treatment alternatives.

One of the most important pieces of information is the treatment-acceptance rate among your patients. This helps you determine whether you successfully convey the types of services you offer. If your practice is not achieving a high acceptance rate (70 to 75 percent), it may indicate the need to re-evaluate your treatment-presentation protocol.

In most offices, the importance of the continuing-care patient demands close attention. Tracking patients` recall frequency is critical. Also critical to the progress of the dental office is paying careful attention to what additional services are being offered and accepted by patients-of-record.

Showing Our Appreciation

We always have been committed to differentiating ourselves by providing new patients with an exceptional first visit to our office. We have found that separating the initial consultation from a "cleaning" appointment increases patient-treatment value.

First impressions are a key to inspiring your new patient to accept treatment, refer their colleagues and keep coming back. For your practice to reach beyond average and achieve its potential, you may need to rethink your entire patient experience.

Although we employ a number of patient acknowledgments to demonstrate our appreciation, the most effective marketing we do with our patients is to make them feel as though they are our only concern while they are in our care.

We are careful listeners and never discount the feelings of our patients. Our fees reflect the level of skill we provide, the quality of materials used and the time required to satisfy the patient. Our fee structure requires that we give our patients our full attention.

When appropriate, we give patients a token of our appreciation. We purchase a number of "gold-coin" gift certificates from the most popular mall in the area. The gold coins may be spent in any store in the mall. We keep these certificates on hand to give them to patients who are having birthdays, anniversaries or other special occasions in their lives. (We also give them to our staff when they go "above and beyond the call of duty.")

During a long cosmetic case-delivery appointment, we may have the patient`s car detailed in our parking lot. When the patient leaves the office with his/her enhanced dental appearance, the car`s appearance has been enhanced by us, too, reflecting the owner`s renewed awareness of the importance of esthetics!

Facility Facelift

Your office setting must reflect the care and attention that you provide your patients. State-of-the art equipment, impeccable cleanliness and organization must be visibly demonstrated. The appearance of your office should be compatible with the art and science of advanced dental procedures.

Professional degrees and certifications of accomplishments should be displayed in patient areas. Membership in affiliated organizations should be prominent. Accreditation in allied groups, such as the American Academy of Cosmetic Dentistry, should be highlighted.

The reception room is an often-overlooked venue for introducing the types of services you offer. New technologies offer exceptional reception-room patient education. Literature and patient-reading material should be carefully selected to direct the patient`s attention to dentistry.

Creating a patient-education center in your reception room is an excellent way to inspire interest in elective procedures. It also will differentiate your office from the standard experience of dental offices in the past.

We started with a patient education video we produced ourselves. There are excellent commercially-made videos on the market. Many of them allow you to custom-design your photos and text.

Another format for reception room presentation is CDI or Compact Disc Interactive systems. CDI systems are similar to VHS players, but use video discs. They can be programmed to run continuously, or the patient can control them through a remote control device. Our reception room plays "Chairtime" by CDI Intervision. It can be programmed before and after cases continuously on the monitor.

The same technology can be used for patient education. A variety of subjects can be accessed, and audio messages provide patient education in conjunction with the visual images on the screen. We use the CAESY patient education system in our treatment and consultation areas.

Photography and Technology

One of the first tools we began using was dental photography. Excellent documentation, self-evaluation, production of "before and after" photo albums, publication illustrations, and presentation aids are only a few uses for this visual medium.

We prefer 35 mm slides, but even Polaroid instant pictures can be useful. We use a Vivatar slide printer to make instant Polaroid pictures of slide images. We include before and after photographs with our post-treatment, follow-up letters.

Today, instant images can be captured with intraoral video cameras, as well as digital cameras. Prints can be made immediately or stored in computers for later use.

The intraoral camera proved to be another important tool in the growth of our own practice. It has allowed for co-diagnosis and better visualization for both the patients and the dental team. It provides excellent communication support and has increased the awareness of dental needs by our patients. The impact of this one, powerful tool on our profession is immeasurable.

We have utilized video-imaging in our practice for many years. When patients can see a simulation of finished treatment on their own image, desire for the treatment often is increased. We use computer-imaging on the majority of our patients, and it has proven to be the tool that has resulted in many patient decisions to appoint for services.

Implementing innovative-technological resources to educate and motivate patients illustrates your attitude about providing state-of-the-art care. Investing in technology can improve patient comfort greatly, as well as acceptance and understanding.

Ultimately, patients are the source of all revenue. All the expensive technology is of no value if patients walk away unconvinced, unpersuaded and unwilling to schedule care.

The Written Word

Practice brochures should be designed like travel or resort brochures. They should invite the reader to the office. The information contained in a practice brochure should describe the quality of care and the types of services available, from the consumer`s point-of-view.

The patient welcome letter (see example on page 72) should be designed to be an invitation. It should be printed on quality paper stock. If an office image or logo is used, it must be trend-setting, not oversaturated in the dental community.

The paperwork that the patient sees-i.e., the practice brochure and patient registration forms-also should be well-written and printed on excellent paper.

Referrals should be documented and acknowledged. Referral gifts should be carefully selected to meet the individual`s particular interest or taste.

Contacting other "appearance professionals" in the community provides a resource for referrals. Plastic surgeons, modeling schools, and estheticians are all potential total-treatment partners in your patient care. Offering evening or weekend informational programs for dental peers or other health professionals can be a way to become recognized in the community on health-related topics of interest.

Local newspapers often are looking for stories of interest for their readers. If your office is providing innovative state-of-the-art care, let people know about it. Invite a local publication or television station to visit your office and learn of the new dental techniques and technologies. If you are using electronic analgesia or "dentistry without a drill" (air-abrasive units), your local health editor may want to write an article about you.

Practice Assessment

Increasing the demand for esthetic and cosmetic dentistry in your practice requires a strong commitment to constant learning and renewal. When planning your strategy, pay close attention to your efforts. What worked 10 years ago, five years ago or even two years ago may no longer suffice for you and your patients.

Examine your patient process and ensure that your office protocol meets the need of today`s dental consumer. Create an innovative patient-service protocol and constantly be on the cutting edge of change.

The mission of excellent health-care providers is to serve patients with distinction. The future of private practitioners wishing to enhance the cosmetic segment of their practices is bright and steadily growing.

Dr. Nash is an internationally-respected practitioner and author in the field of esthetic and cosmetic dentistry. He has lectured throughout North America, Europe, Asia and Australia, and is devoted to excellence in cosmetic dentistry. He is a publisher of a dental-photo book, educational videos and audio tapes and co-director for the Ultimate Esthetic Practice program for the Americus Group in New York. Debra Engelhardt-Nash is a business-management consultant and seminar leader, based in Charlotte, NC. She has over two decades of hands-on experience with business, medical and dental practices and has presented workshops nationally and internationally.

Hallmarks of a Successful Cosmetic Dentistry Practice

Finding the right image starts right inside the front door

The Intangibles

Quality never is an accident. It always is the result of high intentions, sincere effort, intelligent direction and skillful execution. It represents the wise choice of many alternatives. Doctors need to be technically excellent and use effective management principles. To be effective in both areas requires not only a strong commitment, but that commitment must be demonstrated. That commitment must initially come from the doctor!

Practice philosophy and mission must be translated into the everyday life of the practice. If the practice is to truly reflect the vision of the owner, the team must know the doctor`s values, philosophy, goals and standards. These attitudes are directly determined by the doctor and will set the tone for team support and marketing effectiveness.

Spend time examining your practice protocol and ask, "What are we trying to accomplish?" "Do our daily actions live up to our mission?" "How do our patient protocol and office systems demonstrate our philosophy?" "Do they reinforce our quality of care or do they demonstrate a willingness to overcompromise and underdeliver the quality of care we know we can provide?"

When the doctor clearly defines his attitudes about patient care and treatment objectives, the team can create office protocol in accordance with practice standards. Business systems can be designed to match practice philosophy and monitored with clear objectives in mind.

The Tangibles

Service is what one person gives to another. For service to be excellent, people who serve must feel good about themselves and how they earn their living. The wise doctor makes sure that every office function is seen as an opportunity to serve. When a high value is placed on services rendered, employees look for ways to perform beyond patients` expectations and for ways to give more value to each patient.

To prosper and excel today, a dental practice needs to treat employees who, by their commitment and behavior, will present the practice in the best way. Employees who are treated with respect and gratitude will give more, becoming increasingly valuable to the organization.

Communicating effectively with patients is an important factor in differentiating your practice from your competitors. All staff members must be expert communicators.

Communication techniques are used in every aspect of patient care, including:

- Telephone skills.

- Patient introduction to the practice.

- Introduction to treatment.

- Presenting office protocol and procedures.

- Financial arrangements.

- Scheduling.

Providing your best care to your staff is an exceptional marketing tool. Our receptionist "models" veneers every day. She constantly shares her genuine enthusiasm for our work with our patients. Investing your time and talents in your staff`s esthetic and cosmetic treatment creates winning results.

Where Dr. Nash shows his pictures

Some of the ways we have used photography to increase patient demand for our services are:

- Before-and-after photo albums to illustrate possibilities to our patients.

- "Wall of Smiles" in patient areas.

- Before-and-after pictures sent to patients with treatment-completion letter.

- Presentations at community organizations, such as Rotary or Junior League clubs.

- Illustrations for articles in local magazines or newspapers.

- Television interviews discussing new procedures and materials available.

We are honored by your call for an appointment

A warm welcome from our office. Thank you for choosing us to contribute to your dental health and well-being. Most of our clients come by referral. When one recommends us to a friend, we consider it a great compliment.

We take pride in two things-how we treat our clients and the quality of our work. To us, these are inseparable. Quality is critically important to us because it`s not enough to say we care. We need to demonstrate our commitment. Our mission of caring directs everything in our office, including taking advanced specialized training in major areas of dentistry so we can provide a full range of treatment, including preventive, restorative and cosmetic dentistry.

Esthetic dentistry. A beautiful smile is now accessible to nearly everyone. It has come of age with durable, natural-looking materials and procedures, including tooth-colored fillings, and porcelain to restore both function and beauty. We believe when teeth are functional, they are also beautiful.

Healthy structures. Our commitment to making beautiful restorations includes concern for the health of the gum and bone supporting the teeth. We emphasize meticulous cleaning, both when we clean your teeth and when we teach you to keep your teeth clean and healthy.

Creating the ideal bite. We focus on the relationship between joint pain and the way teeth come together (occlusion). Our emphasis on an accurate bite comes from intensively studyng full-mouth reconstructive dentistry.

Many dentists consider this the most complex and demanding procedure in dentistry, but to those who need this service, a satisfactory result may mean the end of long-standing discomfort or preservation or oral function for a lifetime.

Besides his/her work in the office, Dr. _________ contributes to dentistry by editing books and newsletters for dentists in advanced esthetics. This also keeps his/her knowledge of materials and applications on the leading edge.

We hope you are comforted to know that our office strives to meet your dental needs at a high level. All of us really love this work and feel fulfilled when the results are excellent and when we become friends.

We hope this letter has conveyed the sense of pride we have in our work and how important this work is to us and why we are pleased you have chosen us.

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