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GIVE YOUR PRACTICE AN EXTREME MAKEOVER ... AND KISS YESTERYEAR GOODBYE

Aug. 1, 2004
The popular television show "Extreme Makeover" has opened up the world of cosmetic and aesthetic dentistry to mainstream America.

Debra Engelhardt-Nash reveals the beauty of cosmetic and aesthetic dentistry

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The popular television show "Extreme Makeover" has opened up the world of cosmetic and aesthetic dentistry to mainstream America. Driven by aging baby boomers who seek to stay healthy and look young, the demand for cosmetic and aesthetic dentistry is increasing at an amazing rate. Shows such as "Extreme Makeover" have shown patients what is possible, driving consumer demand for procedures such as whitening, adult orthodontia, and veneers.

Practices should be ready to meet this demand for many reasons. Cosmetic and aesthetic procedures represent opportunities to provide more services to patients, increasing revenue potential and practice growth. These procedures typically command higher fees, and typically these services are not covered by insurance. This means the fees established by the practice are not subject to adjustments to meet restrictions of "usual and customary" fee allowances by participating insurance companies. Adding these services to treatment opportunities helps practices utilize existing patients more effectively, as well as attract more patients to the practice. There is also an issue of losing patients and revenue if you don't provide or promote cosmetic and aesthetic procedures. If a patient is interested in this type of dentistry but isn't aware you can do it for her, she may look for a practice that proactively promotes these services through advertising or on the Internet, or a friend or business colleague might refer her to a cosmetic- and aesthetic-focused practice.

Change your perspective on dentistry

Practices that routinely offer cosmetic and aesthetic dentistry have a different perspective and make these types of procedures an integral part of their patient protocol. This perspective creates a new way of viewing recommended treatment. Because team members understand the advantages of cosmetic and aesthetic dentistry, they often begin with the end in mind and focus on the mouth's function, health, and appearance.

Developing a cosmetic practice requires commitment and focus from the doctor and involves the entire team. When working with a cosmetic patient, there's more captive chair time, and the doctor must be comfortable doing this type of work and developing a new kind of patient relationship. Although you may see fewer patients each day, time spent with each patient may increase. You cannot squeeze in a cosmetic case between appointments.

In addition to great technical skills, the doctor also must become a great listener. To make a cosmetic patient happy with the end result, you must begin with her needs and expectations, then gain a true understanding of what she hopes to achieve. Similar to cosmetic surgery patients, many dental patients believe cosmetic dentistry will change everything about them. Again, the doctor must be willing to spend the time and be able to have a dialogue with the patient to ensure her expectations are realistic.

The first step is patient education

Every patient — whether existing or new — who walks through your front door should be aware you provide cosmetic and aesthetic procedures. Even if a patient has been coming to your practice for years and has never talked with you about enhancing her smile, don't assume she is not interested. It is your job to let patients know all options that will help them achieve health for their mouths and beautiful, younger-looking smiles.

Patient education must begin the minute patients make contact with your practice. There are many ways to accomplish this. First, introduce cosmetic and aesthetic dentistry in your practice-development materials. These may include your business cards, the practice's on-hold messaging, Web site, and all practice communication including the new-patient letter, practice brochure, and email correspondence. When patients enter your practice, they want to see visuals that highlight their doctors' great work through before-and-after photos placed throughout the office, displayed during the treatment discussion, or placed on a Web site. Living testimonials of staff also are effective in showing the possibilities and the expertise of the doctor. And finally, the best way to educate patients is simply by talking to them.

Use every patient interaction to educate patients on cosmetic and aesthetic procedures. Never assume that just because they haven't specifically asked for your recommendation, they aren't interested. Here's an example of a patient situation that illustrates how the team can help educate patients on cosmetic and aesthetic options. Let's take a patient who doesn't need additional restorative or preventative dentistry. He has taken great care of his mouth and is in the practice for a regular hygiene appointment. Normally, the hygienist or doctor sees the patient and sends him on his way without discussing cosmetic or aesthetic possibilities — unless the patient specifically asks for information. In a practice with a cosmetic and aesthetic focus, the following dialogue is more common:

"Mrs. Smith, your oral health is looking great. Working in partnership, we have been able to maintain a high level of dental health. When you first came to us, we had an oral care issue that needed attention, but now you are ready to consider another level of dentistry — those procedures that can improve the appearance of your teeth and your smile. I am sure you are aware of Dr. Bradley's excitement for new techniques and materials and his commitment to provide his patients with the best care possible in dentistry today. May I show you some examples of what he has been doing for some of our patients?"

Get started by understanding where you are

Oftentimes, practices look at their production statistics in general terms, such as the number of new patients per month. But that doesn't give you the information you need to develop action plans that will expand your practice. One of the most important statistics to monitor is the average treatment plan presented vs. the average treatment plan accepted by patients. When you look at this statistic, you will be more specific about real issues and make applicable recommendations, instead of making generalized statements such as, "We need more patients," "We need to up our production," or "We need to bring up our collections," that give no specific direction. If your average accepted treatment plan is high, say $3,000, then to increase practice production, the solution may be as simple as bringing in more patients. But if your statistics show your average accepted treatment plan is only $400, and that 70 percent of your recommended treatment remains incomplete, you may want to improve your treatment presentation skills or increase awareness about comprehensive treatment. Also, consider offering patients financing programs so they may accept more comprehensive or cosmetic treatment.

It's important to let patients know their options so they may make choices for healthy, beautiful smiles. The most popular cosmetic and aesthetic procedures are the ones practices should consider offering first. They include whitening, veneers, and aesthetic or natural-color materials. When patients need new fillings or fillings replaced, let them know they have choices in materials and they don't have to go with a metal. Even though insurance typically covers only standard materials, given the choice, many patients will go with the aesthetic alternative and happily pay the difference. Patients will find a way to buy what they want, especially when it is based on meeting emotional needs such as cosmetic dentistry. You may help them by providing convenient payment options. I recommend patient financing because it offers 12-month, no-interest financing to the patient, and you get paid right away. Your patients get beautiful mouths and may pay over time — and you get to do higher-end dentistry that can significantly impact practice productivity.

Marketing your cosmetic and aesthetic practice

We are so conditioned in dentistry to tell patients what they need that we don't ask them what they want. Once you get the right mindset, protocols, team involvement, and patient education, the next step is marketing your talents and services to your community. There are many effective, inexpensive ways to market. In today's Web-connected world, the Internet is the No. 1 way to market a dental practice — especially for cosmetic and aesthetic procedures. Remember the market you want to attract — baby boomers. Statistics show 97 percent of boomers have DSL access. That should indicate their dependence upon the Internet for information. Remember: It's one thing to create a Web site, but it's another to make sure it can be found, so work with a service that will optimize your site and place it on appropriate search engines.

Another place to market your cosmetic and aesthetic practice is high-end community magazines. Frequency is key. You cannot run one ad and expect results. Budget for at least one quarterly placement. Becoming the authority in your community can be invaluable. Make yourself visible and available to local organizations and the press as a resource on cosmetic and aesthetic dentistry. One last point I'll make about marketing — you don't need to advertise a low price or discount. Offer service, convenience, and value instead. You can even promote the availability of no-interest financing. These things make a difference to time-poor, credit-dependent baby boomers.

Focusing on cosmetic and aesthetic dentistry is a shift in philosophy that will dramatically change your practice and your patients. You will attract and retain more patients, who will become walking advertisements for your technical skills. Your practice will benefit from performing higher-end procedures, and your production per patient will increase. With the aging population and the boomers looking to retain their youth, the demand for these types of procedures will continue to grow. Make sure your practice is prepared to do great work and give patients the beautiful smiles they've always wanted through cosmetic and aesthetic dentistry.

Do Your Whitening Patients Suffer from Dentin Hypersensitivity?

Tooth whitening procedures are a common cause of dentin hypersensitivity. In fact, up to 75 percent of whitening patients may experience sensitivity due to whitening. What's more, dental practitioners often advise patients to stop whitening treatment, presumably because patients complain that they are unhappy with the resulting sensitivity.

Fortunately, there are treatment solutions for dentin hypersensitivity, including the utilization of products containing potassium nitrate, such as Sensodyne®.

Dentin Hypersensitivity is a short, sharp pain arising from exposed dentin in response to stimuli. Stimuli are typically thermal, evaporative, tactile, osmotic, or chemical. In order to correctly diagnose dentin hypersensitivity, the patient pain cannot be assigned to any other form of defect or pathology.

The prevalence of dentin hypersensitivity is higher than most professionals think. In fact, one in five adults in the United States suffer from hypersensitivity and few sufferers seek professional care. Dental professionals should routinely screen for dentin hypersensitivity.

In addition to patients who use tooth whitening agents, those at risk for hypersensitivity include:

• People with periodontal disease
• People who clench or grind their teeth
• Aggressive brushers

Contributing factors include enamel loss and gingival recession. Enamel loss can occur from abrasion, abfraction, acid and chemical erosion, attrition, or chipped or cracked teeth or both.

Food and activities can "trigger" pain of dentin hypersensitivity. These triggers include hot or cold food and drinks, sweet and sour foods, and over-aggressive tooth brushing.These stimuli cause the fluid in the dentinal tubules to move rapidly outward or inward, resulting in pain. Patients, instead of seeking treatment, often will adapt their lifestyles and avoid certain drinks, foods, and practices.

Dentin hypersensitivity can be treated in several ways.

Since tooth sensitivity during cosmetic tooth whitening is common, it can benefit both patient and dental professional to address it clinically when it occurs. A desensitizing toothpaste containing 5% potassium nitrate can help to manage dentin hypersensitivity and is easy-to-use. All variations of Sensodyne® toothpaste contain 5% potassium nitrate, which penetrates the dentin tubules and depolarizes the nerves, preventing them from repolarizing. This interrupts the transmission of the pain-causing nerve impulses that normally would be felt as pain.

The use of a desensitizing toothpaste may help those suffering from dentin hypersensitivity manage their condition. Patients may be more likely to complete their tooth-whitening treatment if sensitivity is decreased, resulting in a happier and more satisfied patient.

Sensodyne® desensitizing toothpaste offers eight formulas to help ensure patient compliance. Sensodyne® contains fluoride and the maximum amount of potassium nitrate allowed by the Food and Drug Adminstration, formulated for the treatment of cavity prevention and the treatment of dentin hypersensitivity.

Courtesy of GlaxoSmithKline Consumer Healthcare, LP

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