Gems Publishing - December 2018

Blow the Roof off ‘Usual and Customary’ Dentistry, Part III. Conclusion

By Dr. Tom “The Gems Guy” Orent


that first phase of care, there should be sufficient trust and a strong enough relationship by the first recall visit.

The most common “bread and butter” patients we see in general dental practices typically have lots of work to be done but NO CLUE that there’s anything wrong … let alone any inkling that they need extensive expensive restorative care! “Doc, I just moved from Chicago. Lived there all my life. Loved my dentist, Dr. Bob. In fact, my parents went to him when they were kids too! He’s amazing. 92 years old and still practicing. Gosh, he must love being a dentist! Anyway, he personally cleaned and checked my teeth just about six months ago. He said everything was just fine. Guess all I need now is a cleaning and a quick checkup …” Classic! New patients who have no symptoms may assume that things are just fine. Meanwhile, you take one look and know that you’re in for a difficult discussion about the need for care (in the absence of symptoms). Furthermore, hearing about the cost of that care could easily send your brand-new patient running out the back door. In Parts I and II, we discussed how to avoid sending patients running. If you missed those articles go back to the last two issues now and read them. You’ll discover exactly how to RETAIN ALMOST EVERY NEW PATIENT. It’s not that you can’t discuss what they need. If a patient would benefit greatly from $25,000 worth of crown and bridge, it’s our moral and ethical obligation to discuss it with her. But as you discovered in Parts I and II of this series, if you ever actually want to treat this patient, the timing of that discussion is the critical factor. At the end of Part II, we’d completed the Phase I exam and deliberately expressed, almost as an afterthought, that after we’d completed the Phase I care, we’d like to have her back for a more complete and thorough evaluation of the back teeth.

If you’ve been on Planet Gems for a while, you’ve heard me detail my system for selling best-option long-term dentistry before. If you’ve landed recently, this may be your first introduction to the concept. If effectively applied, you will find yourself placing at least one or two more quadrants of best-option crown and bridge per week … one or two more than you currently perform. Oh yes, the math … Although fees vary widely, the average quadrant of inlays, onlays, buildups, and crowns is close to $5,000. If you only added a single quadrant per week, you’d enjoy a $250,000 annual increase in revenue! Many of our members have seen double that increase. Meanwhile, patients are receiving whatever you determine to be the best possible care … “lifetime dentistry.” Your new patient, Betty, is no longer a new patient. She is a recall patient. Betty arrives for her recall visit. Your hygienist, Linda, chats with her briefly just to reconnect on a personal level, followed by the usual updates of medical history, hospitalizations, changes in medications, allergies, etc. “If you ever actually want to treat this patient, the timing of that discussion is the critical factor.” Prior to commencing the 4-step process to sell quadrant dentistry, Linda completes full-mouth periodontal probing and charting. If periodontal infection persists, today is not the day to move forward with diagnosis and treatment planning of crown and bridge restorative care. Barring emergency needs (pain, bleeding, swelling, fracture, etc.), periodontal infection is our primary focus until appropriately resolved. Once we have confirmed sound periodontal health, it’s time to begin the 4-step process. Important: If you have not yet watched my video training on my “Theory of the Bobble Headed Dog,” it’s critical that you do so prior to going any further. Otherwise, what your hygienist must do won’t


Based upon what we learned from the Mercedes study (six positive interactions), after first meeting your new asymptomatic patient for an exam, a cleaning visit, and whatever short visits might be in

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