HOW TO PROFIT FROM...posterior restorations – A proactive path to profit

Dec. 1, 2002
A lot of insurance companies are busy pretending that dentistry hasn't changed. It's business as usual, with lots of amalgams and porcelain-fused-to-metal crowns to be done.

Dr. Fred Abeles

A lot of insurance companies are busy pretending that dentistry hasn't changed. It's business as usual, with lots of amalgams and porcelain-fused-to-metal crowns to be done. But dentistry has changed. And we're lucky that it has! There's a whole new way to look at teeth and restore them. Once you see it, there's no turning back.

A change in the status quo

Dental amalgam certainly is a time-tested material that has survived from the era when people were driving Model-T Fords. I am not here to bash amalgam. But what other profession, industry, service, or product hasn't changed and advanced in over one hundred years? Look at the advances in medicine, transportation, communication, and science, to name just a few. Where were genetic engineering, supersonic jet aircraft, computers, and atom splitting one hundred years ago? Yet, amalgams have remained virtually unchanged for over a century.

From sideshow to main attraction

With the advent of adhesive dentistry, we now can bond a man-made material to natural tooth structure; the result is tremendous strength and predictability. This has opened up a whole new approach to restoring damaged posterior teeth. No longer do we have to remove three perfectly healthy cusps to replace one broken cusp with a PFM crown. Nor do we have to place a material that does not strengthen teeth. We now can help prevent cracking, leakage, and breakage.

We also possess the ability to make restorations that are virtually indistinguishable from a natural tooth, as well as conserve and preserve healthy tooth structure, seal the tooth, prevent sensitivity, and strengthen the tooth significantly.

Welcome to the world of bonded inlays and onlays. These little masterpieces of ceramic and resin, along with just a few changes in your role as your patient's advisor and clinician, can become the financial foundation of your practice.

Proactive equals profit

Do you see a 10- or 12-unit veneer case walk into your office every day? How about a complex implant case or a full-mouth reconstruction case? If you are like most dentists, this doesn't happen every day. But how many old, failing amalgams do you see in your patients' mouths every single day? Twenty? Thirty? Fifty or more?

Most of these alloys have been in place for more than the eight to 10 years they were originally intended to serve. If you look closely and carefully with magnification or an intraoral camera, there can be signs and symptoms of problems: cracks, leakage, re-decay, or undermined cusps. How many crowns or root canals could have been prevented if you had only intervened before the tooth split or broke?

Do you think your patients might be interested in preventing their teeth from breaking or needing crowns? You bet they are! If you asked your patients why they have amalgam or crowns in all of their back teeth, I'm sure the vast majority will tell you, "Well, that's just what the dentist put in there," or something similar. They were never given a choice. But now, patients do have a choice!

Today's dental consumers are more sophisticated and discerning. They want choices. There's a certain segment of the population that wants to incorporate excellence into their lives in any way possible.

These people appreciate and value quality in everything from the fabric in a well-tailored suit to a great glass of wine. These same people want the freedom to choose what school their child will attend. They want the freedom to choose their own healthcare provider. And they want the freedom to choose the level of dental care they receive. They are open to your best and finest care, and they are in your practice right now ... you just need to identify them.

Don't be afraid to offer your patients something better, even if it costs more. Most reasonable and intelligent people, when presented with the advantages and benefits of conservative inlays and onlays, will choose this new option over the treatment methods of the past.

Would you "watch" a tumor grow?

How would you feel if your physician informed you that he had been watching a little cancer for a few years, had been "keeping his eye on it," but now it had progressed?

This is precisely what we do as dentists at times. It's like watching a bald tire and waiting until it blows out!

Instead of watching teeth until the damage becomes so advanced that the tooth breaks and the patient is in pain, why not offer your patients the best care available now and help prevent further deterioration and damage from occurring?

Be proactive in your life and practice. We've made great strides in preventing decay and periodontal disease. Why not help our patients prevent fractured teeth, crowns, and root canals too?

Patients will respond to a confident presentation that will help them prevent more extensive dentistry down the road. They will trust you and follow your advice with few exceptions.

Advanced training

Reading an informative article, watching an educational video, or attending a one-day course is a great start. However, if you really want to master the art of posterior restorations, then take the time to get advanced training from one of the premier postgraduate programs available throughout the United States. It can make a world of a difference in your skill, enjoyment, and profitability in providing this type of care.

The old saying, "You have to spend money to make money" certainly applies to dentists' education and skill level. As your knowledge, experience, and skills increase, you become worth more than the dentist who only goes to the state meeting once a year. You can command a higher fee than your golfing buddy who spent his continuing-education money on a new boat. Over the course of a few years, this can make an enormous difference in your satisfaction and profitability. When you provide a service that is superior in every way to the average dentist, you can charge what you're worth.

Your fee will no longer be based on an insurance company's UCR or your friendly PPO's fee schedule. An investment in your future now can make all the difference in the future.

Use a great lab

The dental laboratory you choose to work with can have a huge impact on the final result of your restorations. Your complete confidence that the posterior restoration you create will drop into place, look great, and fit is money in the bank. You actually will save money in the long run by spending more up front. Invest in the best instead of trying to saving a few dollars. You'll only lose that money with costly remakes and frustration from improperly fitting restorations. Do yourself and your patients a favor ... use a quality lab.

Seeing is believing

It's one thing to talk about a crack or re-decay in teeth; it's entirely another situation to show them on a television monitor larger than life. Use your intraoral camera. If you don't have one, then run — don't walk! — to your friendly dental supplier and purchase one. You can help your patients co-discover their dental problems by showing them what you see. The camera doesn't lie! You will do far less talking and far more prepping when you utilize this invaluable technology. It helps your patients understand and accept the fine dentistry you are proposing and enhances trust and rapport.

While we're discussing cameras, all dentists should photograph all inlay and onlay cases with a 35mm camera and print film. This serves three important functions:

• It will make you a better dentist when you critique — and improve upon — the end product.

• It communicates to patients that you are serious about and proud of what you do.

• It will allow you to create a large library of beautiful before-and-after photos to show your patients.

Never underestimate the power of visual communication.

Make it affordable

As we provide more complete and comprehensive posterior dentistry for our patients, the average fee per case can move well into the thousands or tens of thousands. Here is one area where we can learn a lot from large and successful retailers.

You don't have to look far to see offers in the newspaper, magazines, or television for products like automobiles, furniture, home entertainment systems, or exercise equipment. What is the one thing they all have in common? They all promote their products by changing the consumer's focus from the total cost to how much they will pay per month. "Lease a new Infiniti from $425 per month ... Buy a room full of new furniture at Rooms To Go with no payments until October 2003." We've all seen the ads. But have you really analyzed why they all sell their merchandise this way?

Corporate America understands that this is how the consumer is most likely to purchase a "big ticket" item. Providing the very best care for our patients means our fees will move into this "big ticket" arena. This type of dentistry is independent of what an insurance company will pay. Treatment plans are for the quadrant or full arch. Patients who will value this level of care need help and guidance in how to pay for it.

It's not enough to merely have the clinical and diagnostic skills to treatment plan this new dentistry. We must become innovative in helping our patients purchase our services. We can offer the same flexible finance plans that your patients have for other large discretionary purchases. There are a host of financial service companies such as Dental Fee Plan, Care Credit, and Wells Fargo Financial that are eager for your patients' business.

Don't focus on the profit

Interesting advice from an article entitled "How to Profit From Posterior Restorations," isn't it? But if you play championship tennis, you don't win many matches if you stare at the scoreboard. You win by keeping your eye on the ball and focusing on your game. If you do that exceedingly well, the score will take care of itself. It's the same with dentistry. If you make the decision only to provide the very best for your patients, get advanced training, use the right lab, and stop "watching" old, failing restorations, the money will follow ... effortlessly.

Turn old patients into new patients

Remember how excited you felt the first time your marketing efforts produced 10 new patients? Just wait until you realize you have an office full of new patients! Expensive advertising and marketing often have inconsistent results. Yellow page directories, newspapers, magazines, direct mail, and radio and television ads are all quite expensive mediums to attract new patients.

When launching a new service into your practice, such as bonded inlays and onlays, every patient in your practice becomes a "new" patient. They need to be introduced to the wonderful new services you can provide.

There are lots of ways to attract new patients, but only one will make you a better dentist. Instead of spending thousands of dollars on marketing efforts to attract new patients, why not invest in yourself and your education? When you master the clinical skills to provide these exciting new posterior restorations to your patients, then every patient will become a "new patient."

Have a better plan

If you want to have a happier and more fulfilling practice, you will need a better plan than the average dentist.

Plan now for your future success through advanced education, using the finest labs, and utilizing photography and imaging. Stop watching teeth and start providing your absolute best and finest posterior restorations for your office full of "new" patients.

There's never been a better time to be a dentist. A whole generation of aging Baby Boomers has old, failing restorations. They want to look better, feel better, and be healthier. Providing state-of-the-art posterior restorations can become the cornerstone of your practice.

Well, there you have it ... some simple and effective ways to increase your pride and enjoyment in delivering posterior restorations. Oh yes ... you'll be seeing more profits too!

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