Making people happy

Dec. 2, 2010
Patient satisfaction is an area that many of us in dentistry take for granted. Every dentist I meet is as careful as possible in trying to do the best dentistry they can.

Louis Malcmacher, DDS, MAGD

For more on this topic, go to and search using the following key words: making people happy, patient satisfaction, dreaded shot, Dr. Louis Malcmacher.

Patient satisfaction is an area that many of us in dentistry take for granted. Every dentist I meet is as careful as possible in trying to do the best dentistry they can.

A restoration may look great, the margins may be perfect, and the occlusion impeccable, but the patient may leave and still not be satisfied with the results. Some argue that this really doesn't matter; as long as the dentistry is perfect, the patient's attitude is insignificant.

I strongly disagree with that contention. Patient satisfaction is part and parcel of excellent dentistry. It's almost become a cliché to say we are not just treating teeth; we are treating people.

The reason I think it's a cliché is because I see a lot of lip service given to this idea, but I don't see a lot of action behind it. If you do excellent dentistry, but the patient has a poor experience, then I would strongly suggest that it is no longer excellent dentistry.

It's not only what you put in the mouth that counts, but also how well you treat the patient. In that way, patients learn to appreciate the overall dental experience, recommend you and your office to their friends, and will keep coming back to maintain their oral health. The point of an overall great patient experience is for them to come back and maintain excellent oral health for the rest of their lives.

The dreaded shot

The most dreaded part of any patient experience is the awful shot and local anesthetic. There is no way around it; it hurts. I know so many dentists who believe they give excellent injections, and they do, but many patients' experiences are diametrically opposed to what we feel on the other side of the syringe.

You and I have used all of the time-tested techniques – soothing talk, wiggling their cheek, telling them it's not so bad, topical anesthetic that works psychologically more than clinically, and more.

It's about time that we got serious about patient comfort with dental anesthesia. Here are a few options:

1 Laser dentistry – From a cost and ROI standpoint, there is no better time to get into laser dentistry than with the introduction of a new and very affordable hard and soft tissue laser, Lightwalker (Lares Research), and the recent price reduction of the Waterlase lasers (Biolase). These will eliminate most of the injections associated with many dental procedures. With the end of the year coming up, it is a great time to get into laser dentistry. At a minimum, become a laser dentist by getting a Picasso Lite diode laser (AMD LASERS), the lowest priced and one of the best soft tissue lasers around.

2 Single tooth anesthesia – Let's bring back the periodontal ligament injection into every dental practice. This can be given very effectively manually, and requires a slight learning curve and some review of the microanatomy around the teeth. I was lucky to learn this injection early in my career, and I use it almost every day in my practice. With an investment of time and technology, you can also use the STA by Milestone Scientific, which will significantly help you give a PDL injection. Learn the advantages and disadvantages of a PDL injection and use it where it will be most beneficial.

3 DentalVibe with vibrapulse technology – Based on the pain gate theory, the brain cannot process too much stimuli at one time. One of the innovative new devices in this field is called the DentalVibe. This is an outstanding new technology that will retract and illuminate the tissue while emitting an intense vibration and pulsating action so that the brain cannot get used to the constant vibration and then filter it out. This incredibly cost effective device will allow you to give pain-free injections for the first time ever in dentistry, both intraorally and with extraoral Botox injections.

There is no question that clinical excellence is of utmost importance to a dental practice. Let's put patient satisfaction right up there with clinical excellence – without patients in your chair, you won't be able to use all of your great clinical skills. Giving the most comfortable injection possible will reduce your stress and give you and your patients a more satisfying experience.

Dr. Louis Malcmacher is a practicing general dentist and internationally known lecturer, author, and dental consultant known for his comprehensive and entertaining style. An evaluator for CLINICIANS REPORT, Dr. Malcmacher is the president of the American Academy of Facial Esthetics at Contact him at (440) 892-1810 or e-mail [email protected]. His Web site is, where you can sign up for a free monthly e-newsletter.|It's about time that we got serious about patient comfort ...

More DE Articles
Past DE Issues

Sponsored Recommendations

Clinical Study: OraCare Reduced Probing Depths 4450% Better than Brushing Alone

Good oral hygiene is essential to preserving gum health. In this study the improvements seen were statistically superior at reducing pocket depth than brushing alone (control ...

Clincial Study: OraCare Proven to Improve Gingival Health by 604% in just a 6 Week Period

A new clinical study reveals how OraCare showed improvement in the whole mouth as bleeding, plaque reduction, interproximal sites, and probing depths were all evaluated. All areas...

Chlorine Dioxide Efficacy Against Pathogens and How it Compares to Chlorhexidine

Explore our library of studies to learn about the historical application of chlorine dioxide, efficacy against pathogens, how it compares to chlorhexidine and more.

Whitepaper: The Blueprint for Practice Growth

With just a few changes, you can significantly boost revenue and grow your practice. In this white paper, Dr. Katz covers: Establishing consistent diagnosis protocols, Addressing...