When Patients Cancel Appointments

October 17, 2018 Pankey Gram

How you schedule in your dental practice can significantly impact productivity. If patients are arriving late, not showing up at all, or moving their appointments a lot, you may have a minor crisis on your hands.

There’s no reason to stress when efficiency is only a few simples changes away:

Efficient Practice Scheduling

Scheduling effectively is largely determined by how much patients value your services. Are you and your dental team doing your part to make patients feel respected, cared for, and treated with the highest level of attention possible? Do your patients understand what services are provided during a hygiene appointment? Do they value oral healthcare or know how it can affect the entire body? Do they understand their individual risk factors and how routine care supports managing and minimizing these risks?

All of these are questions you should ask before going out and searching for answers to a mysterious lack of practice growth. Also, you should consider how you set up the daily schedule. Are you moving more intensive cases to the beginning of the day when you and your team are fresh? Do you have enough energy, are you arriving late to the operatory, are you running behind? If patients feel like you aren’t respectful of their time they may not be respectful of yours.

The simple change is to engage your team more. Are your hygienists and dental assistants taking the reigns as much as they can for procedures and managing the schedule? Are they an integral part of developing patient relationships, creating ownership and building an atmosphere where patients want to keep their appointments? The team is also a key component of schedule flow. Are they being utilized effectively to complete clinical procedures? This can be a key to maximizing your productivity without chronically running behind.

Have your hygienists complete their assessments at the beginning of appointments so you can drop in whenever it’s most convenient. That way patients aren’t waiting for you if you get trapped in a complex situation. All of the above are ways in which your schedule could be improved.

How do you maintain steady growth and increased productivity on a yearly basis? Please let us know your favorite tips or recent changes! Also, we have a feeling you’ll love this blog on setting splint therapy fees … 

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Transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the Key, and Aesthetic and Functional Treatment Planning is where your journey begins.  Following a system of…

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On Providing a Fix vs an Experience: Part 2

July 11, 2018 Will Kelly DMD

When a car breaks down, the way we choose to have it repaired says a lot about how much we value our vehicle. A similar phenomenon occurs with dental care. 

In part 2 of this series about how we see a fix versus a valued service-based relationship, Dr. Kelly dives back into an experience that made him reflect on the dental profession. Keep reading for the rest of his story:

A Car Service Analogy: Obligation, Expense, or Experience

Coincidently, many days I use the analogy of cars to taking care of teeth with my patients. We wear away the surfaces of our teeth similarly to how tires age. We pay for maintenance and parts with an equal financial obligation and expense.

When we have to start over and restore our vehicle (or get a new one), sometimes it costs the same as major treatment we could have done for our teeth. Sometimes the auto investment is inconvenient and urgent. Often, if we choose, it is predictable and pleases us. We find ways to pay for it.

Individuals always seem to find ways to pay for the things they value. We choose our own experiences whether we know it or not. I invite my patients to consider experiencing dental care in my practice similarly to the good experience I have had with reliable and well-maintained cars.

The business card for my practice has three tag words on it: Restorative, Comprehensive, and Esthetic. I’ve been told that the meaning of these descriptors is too obscure for new patients to understand. Why not be like the dentist down the street and just say “Cosmetic” or “Family Dentistry”?

I believe every opportunity I have to help patients experience each of these focused goals for our patient care enriches the dentistry I can provide them. So many in our patient family have learned through these experiences exactly what these words mean.

To be continued …

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Dr. Will Kelly attended the North Carolina State University School of Design and received a BA in Communications. He went on to spend two additional years in post baccalaureate studies in Medical Sciences at both UNC Chapel Hill and Virginia Commonwealth University. Dr. Kelly graduated from the top ranked UNC School of Dentistry in 2004. His good hands and clinical abilities led to his being chosen as a teaching assistant to underclassmen in operative dentistry. In addition to clinical time in the dental school, Dr. Kelly had valuable experiences working in both the Durham VA Hospital and for the Indian Health Service in Wyoming. As a child, Dr. Kelly had the opportunity to assist his father on several dental mission trips in Haiti. After completing dental school, Dr. Kelly joined his father in private practice and served on the dental staff at Gaston Family Health Services, where he maintained a position on the board of directors. At this time Dr. Kelly also began his studies in advanced dentistry at the prestigious Pankey Institute in Miami, a continuing journey of learning that has shaped his philosophy and knowledge of the complexities of high-level dentistry. Today Dr. Kelly devotes over 100 hours a year studying with colleagues and mentors who are regarded as "Masters of Dentistry".

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On Providing a Fix vs an Experience: Part 1

July 9, 2018 Will Kelly DMD

What makes dental care a valued investment versus a fix patients choose begrudgingly? 

One morning I had an automobile breakdown in my “beater” weekend truck. We have all been there – filled with the inconvenience and anxiety of dealing with a problem that came up unexpectedly. I was hoping to find a place that could get me home that day.

I googled around until I found a reasonable looking repair shop close to the breakdown. They worked me into their schedule so I could get the old truck back on the road. It was pleasing to have the problem fixed, at least for that day, but I measured this against how I have experienced service at the shop that takes care of my daily driver car.

Dental Service Emergency vs Dental Relationship

There were many aspects of the breakdown with my old pickup truck that reminded me of a dental emergency. I found someone convenient and they had the best intentions to provide a fix.

It was a shop I didn’t have a relationship with. They were kind and helpful, but there were so many things missing that would have been unlikely to happen if I treated my old truck like I do the car I have been so much more diligent in taking care of.

The shop focused on the problem that was presented to them, not looking beyond a simple fix to get me back on the road. While I was appreciative, it is very unlikely that the next problem (or even the true cause of this one) was looked for. I did not leave with any feeling that I wouldn’t be in a similar situation as soon as the next problem arose.

I reflected on the years I have spent with the auto shop that takes care of my primary car. I have a valued relationship with them. They know me and know that I appreciate them taking the best care of the investment I have in the vehicle I drive every day.

When I take my car to an appointment, they look over everything. They tell me when to expect maintenance and repairs in the near future and throughout the life of the vehicle. I trust them and know that they have my best interest in mind. In return, I am very appreciative, expressing gratitude when I write them a check for their services. I have never broken down in the cars they take care of for me.

To be continued …

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Dr. Will Kelly attended the North Carolina State University School of Design and received a BA in Communications. He went on to spend two additional years in post baccalaureate studies in Medical Sciences at both UNC Chapel Hill and Virginia Commonwealth University. Dr. Kelly graduated from the top ranked UNC School of Dentistry in 2004. His good hands and clinical abilities led to his being chosen as a teaching assistant to underclassmen in operative dentistry. In addition to clinical time in the dental school, Dr. Kelly had valuable experiences working in both the Durham VA Hospital and for the Indian Health Service in Wyoming. As a child, Dr. Kelly had the opportunity to assist his father on several dental mission trips in Haiti. After completing dental school, Dr. Kelly joined his father in private practice and served on the dental staff at Gaston Family Health Services, where he maintained a position on the board of directors. At this time Dr. Kelly also began his studies in advanced dentistry at the prestigious Pankey Institute in Miami, a continuing journey of learning that has shaped his philosophy and knowledge of the complexities of high-level dentistry. Today Dr. Kelly devotes over 100 hours a year studying with colleagues and mentors who are regarded as "Masters of Dentistry".

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Choosing Value First

July 1, 2017 Lee Ann Brady DMD

Why You Should Determine Value Before Chroma and Hue When Matching Shades for Composites

The true artistry of the dental profession tends to show itself in many of the more challenging requirements of cosmetic dentistry. One of these areas where we can express our esthetic skills is in shade matching for composites. The struggle arises in understanding the various properties of natural-looking teeth and determining what visual aspects to match first.

 Composites 101: Defining ‘Shades’ and Their Components

Before you can begin to choose which aspects of a natural ‘shade’ to preference, it’s integral to delve into the nature of these complex components.

Reflectiveness and translucence combined determine the appearance of a tooth. Reflective properties are especially important for shade matching because this is the true definition of ‘value.’ Value tends to be defined as the coloring on a range of white to grey, but it’s actually a measure of tooth reflectiveness.

Other esthetic qualities of dentin and enamel include ‘chroma’ and ‘hue.’ A classic numeric scale of 1 (lowest) to 4 (highest) is used to judge chroma, which simply refers to the intensity of a color. Hue, on the other hand, is generally deconstructed into the letters A, B, C, and D. These indicate the names of color.

‘Shade’ is simply the end result when all three parameters of value, intensity, and hue are viewed together. The key lesson here is that these parameters must be matched separately. To achieve the best case outcome, you must rank them according to importance.

Should You Shade Match for Value, Chroma, or Hue First?

This is where things get tricky and we start to juggle multiple considerations at once.

Layering is paramount because dentin shades and light properties differ in composites versus real dentin. This is also true for enamel shades. Added to these differences is the fact that dentin and enamel do not have the same amounts of reflectiveness and translucence. Basically, you have dentin and enamel discrepancies between composites and real teeth in addition to the discrepancies that exist between dentin and enamel.

Precision will impact the final appearance of the tooth, so it’s important that you layer composites to get around these discrepancies. The composite materials selected should match for value before chroma and chroma before hue. Because final value is a blend of the individual values of every composite layer, you must consider that each layer is not going to be representative of your intended value. They build on one another to create life-like reflectiveness and translucency.

A Method You Can Use for Determining Value in Composites

My favorite method for constructing an esthetically superior value is to start the appointment with layering. I plan what composite shades I want to combine ahead of time and work efficiently so that inevitable teeth dehydration doesn’t affect my results.

I layer the materials on the labial of the adjacent tooth in their final thicknesses and photograph the outcome. This allows me to see if my chosen combinations match my esthetic goals and troubleshoot if the composite doesn’t disappear against the tooth. When I’m not happy with the look, I easily pop the composite off the tooth and re-do the process. I only begin to contemplate chroma and hue once I’ve matched the value.

How do you troubleshoot shade matching issues in your esthetic cases? We’d love to hear your perspective in the comments!

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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