Building a dental practice that emphasizes prevention

Oct. 1, 2011
Recently, an increasing number of dental practices have embraced a new model of treatment that moves beyond the “drill and fill” approach ...

by Peter Blanchard, DDS, MBA; Dental Director, DentaQuest Oral Health Center; Director, Evidence-based Dentistry, DentaQuest Institute

For more on this topic, go to and search using the following key words: profitable practice, prevention, self-management, loyalty, Dr. Peter Blanchard.

Recently, an increasing number of dental practices have embraced a new model of treatment that moves beyond the “drill and fill” approach that has defined many practices for so long. While this shift represents an encouraging sign for patients and their oral health, for dental practices it raises many questions about the suitability of the existing reimbursement and practice-management models. But, during the past 12 years, I have seen in our office that an emphasis on preventive care does not necessarily compromise the growth of a practice. In fact, it can actually serve to strengthen the practice.

Encouraging self-management

The DentaQuest Oral Health Center was founded in 1999 with the goal of partnering with patients to reduce their risk of future disease by eliminating or reducing risk factors that are responsible for creating new disease. Consequently, Caries Management By Risk Assessment (CAMBRA) protocols play a key role in our practice.

This approach is typically a departure for new practice patients, who are accustomed to the everyday drill and fill dentistry performed by many other offices. To help patients acclimate to this method and to reinforce the ways in which our practice is different, we tell patients about our approach in various communications before, during, and after their appointment.

We believe that this patient-centric approach is more effective and encourages self-management, empowering patients to take control of their oral health. For example, if a patient has a habit of frequently drinking low pH, high sugar beverages, we discuss options such as reducing the frequency of drinking, chewing xylitol gum after drinking, or swishing water in the mouth, as opposed to simply telling the patient that he or she should stop this habit altogether.

We also recommend medications that can help patients manage their risk levels at home. In addition to xylitol products, we prescribe high fluoride dentifrices such as Clinpro™ 5000 1.1% Sodium Fluoride Anti-Cavity Toothpaste from 3M ESPE, or chlorhexidine rinses as appropriate for the patient’s needs.

An important measure we take to increase compliance with these medications is to offer them to patients at cost. We inform patients that we believe in the benefit of the medications so strongly that we are willing to forego a profit on their sale.

Building loyalty

As might be expected, this practice philosophy is heavily weighted toward hygiene and prevention. We employ 3.5 general dentists and nine hygienists. While unusual, this approach has been successful for our practice. We outgrew our first five-chair facility within five years of opening, and now have a state-of-the-art, 13-chair facility.

Patients have responded enthusiastically to our model of treating more patients with less invasive care. We receive a large number of word-of-mouth referrals from existing patients, and currently average 130 new patients per month. We also experience little staff turnover, thanks to our empowerment of hygienists and the freedom we give them to do what they do best.

Our approach has not only helped us gain new patients, but we have received gratifying recognition from the dental community. Last year we were honored as an Adult Preventive Practice of the Year by the American Dental Association and 3M ESPE.

This award was created to recognize dental offices that “demonstrate excellence and innovation through the combination of practical, preventive oral health care, and ongoing patient education.” We are pleased that the dental community increasingly acknowledges the importance and the power of preventive care not only in keeping patients healthier but in building sustainable practices.

Today’s patients are becoming more and more aware of the concept of overall wellness and their ability to proactively manage their health, reverse undesirable conditions, and adopt lifestyles that help prevent disease. As this attitude becomes more prevalent, dental offices that have positioned themselves to help patients take control of their health will reap considerable benefits. Our experience has shown that this approach builds loyalty, increases referrals, and makes the dental team and the patient true partners in fighting oral disease.

Peter Blanchard, DDS, MBA, holds an MBA in health care management from Boston University Graduate School of Management. He received his DDS degree from Georgetown University School of Dentistry. Dr. Blanchard is a national board member and practitioner investigator with the PEARL Network. Reach him at [email protected].

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