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The complete examination

Feb. 1, 2007
When DENTISTS READ A TITLE like the one above, they immediately think of a comprehensive examination, oral cancer screening, two bitewings...
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by Louis Malcmacher, DDS

When DENTISTS READ A TITLE like the one above, they immediately think of a comprehensive examination, oral cancer screening, two bitewings, a full-mouth series or panoramic, diagnostic casts, articulators, periodontal charting, a complete medical history, and a temporomandibular joint examination. Truth be told, if I read another article like the one I just described — telling me how to do a complete examination on a patient — I think I’m going to be sick. I’ve sat through full-day courses on doing a complete examination — courses which did nothing to supplement what I learned in dental school.

In this column, I am going to talk about a different kind of complete examination. This complete examination occurs every minute of every day in your dental office. This is a complete examination every dentist needs to know about and prepare for. I am talking about the complete examination the patient gives you every second he or she is in your office. Doctor, you and your staff are being examined and scrutinized completely by the people who pay you. This is a complete examination that you must pass to have a successful dental office in 2007.

What are your patients looking for while they are doing their complete examination of you? Certainly, it goes without saying that they are looking for quality dentistry in a safe, sterile environment — a line you will see in the mission statements of many dental offices. Don’t you think that most patients take that for granted? I am pretty sure that patients are not looking for a dirty dental office that reuses its anesthetic needles! The major question is, what are patients looking for beyond the basic dental office and what are they judging you on?

Treat the individual, not the mouth

The number one priority for most of your patients is how you treat them. They want you to recognize their individual needs and wants rather than seeing them as another mouth to treat. Let me ask you a simple question that you and every member of your staff needs to answer: “When you come to the office, are you more concerned about yourself or your patients?” If the answer is “you,” then you have failed the examination and patients can see right through it. I teach this to my audiences all the time — the dental office is about the patient, not you! In this day and age when estimates say that 50 percent of dentistry is elective esthetic treatment (based on dollars), you better be much more focused on what the patient wants than on what you want. If you are trying to sell every patient who walks in the door a cookie-cutter full-mouth reconstruction worth $60,000, then your patients already know that it is not about them — they know that it is all about you!

There is so much talk about the dental office being like Nordstrom’s or the Ritz Carlton. Let me make this as simple as I can — you are not Nordstrom’s or the Ritz Carlton! You will never be like Nordstrom’s or the Ritz Carlton. I don’t remember the last time I walked into a Ritz Carlton and heard dental drills whirring and ultrasonic scalers squealing. But, you can treat everyone who walks into your office like they do at Nordstrom’s — that is, as individuals with individual needs. You do this by listening to your patients and catering to their needs and wants before recommending any kind of treatment.

What do patients want? They want minimally invasive, relatively painless, and injection-free (when possible) dentistry. Patients relate to what is state-of-the-art by what they read and see in consumer magazines. The three most popular state-of-the-art techniques patients relate to are 1) one-hour whitening, 2) laser dentistry, and 3) minimally invasive porcelain veneers. You cannot pick up a consumer article about dental esthetics without reading about in-office, one-hour whitening. Whether they need it or not, patients walk into your office ask about one-hour whitening. If you do it, you are a state-of-the-art dentist in their minds.

From a practice management and clinical point of view, it is time to get a dental laser. More than any other piece of technology we have ever invested in, the laser impresses patients the most! Why is that? The answer is because when your patients go to the dermatologist, he or she is using a laser. When they go to the optomologist, the ophthalmologist is using a laser. When they walk into a dental office and find you using a high-speed drill they remember from their youth, they view you as an old-fashioned dentist. I call this the “James Bond experience.”

People really get turned on to lasers because they see them everywhere. The medical professionals have it, James Bond fights the bad guys with a laser ... lasers are the latest technology in manufacturing and so many other things that consumers see all the time. When they fi nally see a laser in your office, you are a state-of-the-art dentist in their eyes and have passed their complete examination.

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Patients are asking more and more about the “oralsystemic link” and how it affects their health. There is no better tool to convince your patients that you are on the forefront of this rapidly growing movement than an examination using the Florida Probe® System, a computerized periodontal probing and charting system. They can see and hear the probing depths, and they also can watch the short periodontal-educational clips that come with the software. They can even take home a state-ofthe-art periodontal chart that visually highlights problem areas in their mouths. They will leave your office knowing they received individual attention because you gave them a personalized risk assessment and a patient diagnosis sheet with specific home-care instructions. With the Florida Probe, the routine periodontal exam has been transformed into a “wow factor” experience that your patients won’t soon forget. The more you give them a complete examination, the more you will pass their complete examination.

Patients want minimally invasive dentistry

I know there are prominent esthetic lecturers who say that patients don’t care about the aggressive preparations as long as they get the desired result. My simple response to that is that I don’t know what planet their patients come from, but I do know that my patients care a lot. Given the choice between aggressive preparation and minimal or no preparation, people (and most dentists I know, since I treat many dental professionals) will opt for minimally invasive dentistry every single time.

The next time any patient walks into your office, remember that you are not the only one giving an examination. Patients are looking at you, constantly evaluating you, your team, and your facility to decide if your offi ce is the appropriate place for them to receive dental treatment. They are constantly interviewing you and using their eyes as their own diagnostic tools to see what kind of dental office you really have. State-of-the-art techniques that patients care about like those mentioned in this article will help you get an A+ on your next exam. Good luck!

Dr. Louis Malcmacher is an international lecturer and author known for his comprehensive and entertaining style. An evaluator for Clinical Research Associates, Dr. Malcmacher is a consultant to the Council on Dental Practice of the ADA. For details about his speaking schedule, Dr. Malcmacher can be reached at (440) 892-1810 or via e-mail at [email protected].

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