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Dental Etiquette for the Patient with Special Needs
by Niki Henson, RDA
A mother whispers to herself as she prepares her child for his first trip to the dentist. He is three years old and still has no signs of teeth. She is nervous on multiple levels… she wonders how the child will behave in this new environment; how will the dental staff look at her child? Will they find my son is also missing his teeth in addition to the other medical and mental problems he has already been diagnosed with? Her stress mounts as the schedule moves forward. She arrives at the dental office, already having a relationship as she has been a patient there herself many times, with an instinctually protective attitude. After signing in, the mother and son attempt to relax in the reception room until they are called for their turn. The dental assistant opens the door to this stress-filled environment and the mother strolls her son’s wheelchair into the operatory. The mother picks up her son and gently sits him down in the dental patient chair for radiographs, her pulse and blood pressure rising as her son’s facial expressions changing to a fearful one. The boy refuses the radiographs, even with repeated attempts and gentle persuasion. When the dentist arrives to help, the child begins to scream in terror seeing another white jacket. Another refusal is made, and the child is dismissed. The mother now begins the search for anyone who can help her son… who still needs dental care. Read more
Bisphosphonate Therapy & Dental Care
by Lee Ann Brady
Reprinted from leeannbrady.com
One of the hot topics over the last few years has been managing our patients who are taking bisphosphonates in order to minimize the risk of osteonecrosis of the jaw. When I think about my practice it seems a higher and higher number of my female patients are on medication for osteoporosis or osteopenia. I decided to look this up and sure enough it is estimated that over 80 million Americans are on bisphosphonates. With that large a number and most of those folks being routine dental patients, what do we need to know? Just today I came across a blog post from my friend Dr. Marty Jablow on a recent ADA report for dentists on this topic. The ADA has complied the data and research between 2008 and 2011 on this topic and produced a report designed to help those of us in practice make some sense of this topic. I spent the morning reading the executive summary of the report and I finally feel like I understand what I need to about this issue.
- Be familiar with the brand names of popular medications used to treat osteoporosis and osteopenia, both bisphosphonates and monoclonal antibody therapy. These are alendronate (Fosamax®), alendronate/cholecalciferol (Fosamax® D), risedronate (Actonel®), ibandronate (Boniva®), and zoledronic acid (Reclast®). Denosumab (Prolia®).
- Document patients who are taking any of these medications.
- The risk of developing osteonecrosis of the jaw is relatively low. It is estimated to be 0.1% or 1 case in every 1000 patients.
- An increase risk is associated with specific procedures that increase bone trauma, particularly tooth extractions, age (older than 65 years), periodontitis, use of bisphosphonates for more than 2 years, smoking, denture wearing, diabetes and extensive surgical procedures.
- ONJ can occur spontaneously in patients taking any of these drugs.
- Make sure and discuss the risk with any patients who are taking bisphosphonates or monoclonal antitbody therapy.In addition the executive summary looked at serum CTX testing to determine patients at risk of ONJ. Their conclusion was that there isn’t enough objective research to support a recommendation for testing in patients who are on these medications. The report also look sat the concept of a “drug holiday”, discontinuing the medication for a period of week to reduce the risk during dental procedures. The summary reports that there is not enough evidence to support this approach.
As a general practitioner the summary reassured me about this topic, whereas up until now I had been uncertain. It reaffirmed for me that the risk from untreated dental disease out weighs the risk of ONJ, and that I can confidently discuss this with my patients so they can chose what is best for them.
7 Steps for Quality Records Appointment
by Shannon Pace Brinker CDA, CDD
1. Start with Quality Impressions: Many diagnostic impressions are not viewed with the same attention to detail that a final crown and bridge impression is scrutinized. If these impressions are going to be utilized to for diagnosis, treatment planning, diagnostic waxing, and eventual provisional fabrication, then it makes sense to obtain extremely accurate impressions.
2. Using one of alginate replacement, polyvinyl siloxane impression materials(Flextime Putty with a light body wash by Heraeus [Fig 1]), is an excellent material way to create and optimum diagnostic impression. It will allow for multiple pours if necessary, and will eliminate the need to pour the model immediately. Be sure to dry the teeth prior to placement of the impression, and be sure to capture all the surfaces of the teeth, extending well beyond the free gingival margins of the teeth, the entire buccal and lingual vestibules, and the entire hard palate.
Figure 1
10 opportunities to impress your patient before treatment is even accepted
By Hollie A. Bryant, RDA
Did you know that there are at least ten potential opportunities that your office has to impress a client before treatment happens? What an awesome opportunity to make an impact on the patient, to gain trust, to build excitement about achieving optimal dental health.
1. The phone call- Place your best team members on the phone! When the phone rings you want to have your best players ready for action. You only get one shot to make a good impression.
2. The New patient packet- Sending out a personalized new patient packet with information pertaining to the patient s specific phone call desires and needs.
3. Verifying the appointment.- Take this opportunity to ensure that the patient received the personalized packet of information, viewed the website, if there any questions about directions and verifying the time of the appointment.
Top 10 Things That Can Keep The Practice Growing.
By Hollie A. Bryant, RDA
10. Be “LIKEABLE”. Take the time to connect with each patient. If people like you then they will do business with you.
9. Be ON TIME. If we say that we are seeing a patient at 3:30pm, then they need to be seated at 3:30 pm. This is what time their appointment begins. Always try to be on time. Our word is our commitment.
8. Speak their LANGUAGE. Patients did not go to dental school; so don’t speak dental terminology to your patients. Explain things in a way that the patient will understand.
The Role of the Patient Coordinator
by Mickey Bernstein, DDS and Diane Bernstein
One of the most amazing roles in the practice is the Patient Coordinator – that person who oversees the ongoing relationship with patients. While the specifics of the position can vary widely from one practice to another, the goal remains the same: ensure that patients are being heard, understood and cared for in the most appropriate way.
The role of the Patient Care Coordinator has evolved over the years, having begun as a hybrid to connect the clinical and behavioral dimensions in the practice. What we needed, many people realized, was a gifted communicator who could focus exclusively on the patient’s agenda and bridge the gap between what the patient wanted and what the practice had to offer. Since the initial conception in the early 1980’s, the role has developed into a key position that, in many cases, has taken the potential of the practice and brought it into reality. In considering the step to add a Patient Coordinator to the practice, the following questions might be asked:
Introducing Lava™ Ultimate CAD/CAM Restorative: A New Class of CAD/CAM Material
Fast and tough material for CEREC®, E4D® and Straumann.
3M ESPE‚ introduces Lava™ Ultimate CAD/CAM Restorative, a unique new CAD/CAM material with long-lasting esthetics and performance. Based on 3M ESPE’s renowned nanotechnology, Lava Ultimate CAD/CAM restorative offers a polish that lasts, and backs it up with a 10-year warranty—something no other chairside block can match.
This new class of CAD/CAM material provides a fast, no-firing process that is easy to mill, helping dentists maximize the productivity of their in-office restorative systems. The unique restorative offers a functionality that other chairside materials cannot: Lava Ultimate CAD/CAM is resilient, not brittle, and is incredibly durable and shock absorbent. A few minutes of polishing are all that is necessary to achieve an enamel-like luster. The material also allows dentists to easily make adjustments, as well as build-up and reseal restorations. Lava Ultimate CAD/CAM restorative will be offered in eight shades, four of which include both high and low translucencies, giving dentists the choices they need to create natural-looking restorations.
Rubber Dam Placement Made Easy
When asking Dental Assistants how many uses a rubber dam in their practice, it shocking to see the show of hands. Studies show that only 15% of dental offices use rubber dam for adhesive procedures. Excuses come up such as; it takes too long to place, we just use cotton rolls, retractors get the same results. With so many new and innovative dams introduced, dam placement takes minutes. Why take chances?
What is a Rubber Dam
The dental rubber dam is a piece of thin, stretchable latex or non-latex material that becomes a barrier when applied to the selected teeth. The isolation technique helps protect the teeth for all types of dental procedures such as root canals, bleaching, and preparation and delivery on all types of restoration.
Read more
Whitening: Gateway to Doing More Ideal Dentistry
by Gary Takacs
Recently, I wrote a blog post about five specific strategies that can help your practice grow in a soft economy. The first strategy I recommended was to make whitening a core element of your practice. In this blog post, I will provide more details.
I am a firm believer that whitening is an under-utilized service in dentistry! The fact is, people want and value whiter teeth. In a recent USA Today survey, 85% of the people surveyed listed ‘make then whiter’ when asked how they would like to improve their teeth. WOW, think about that for a minute. 85% of the people want whiter teeth! The great news is that we have the technology to give patients what they want.
Bad Breath and Helpful Aids
by Ruth Ann Young
Whether you call it bad breath or halitosis, it’s an unpleasant condition that’s cause for embarrassment. Some people with bad breath aren’t even aware there’s a problem. If you’re concerned about bad breath, see your dentist. He or she can help identify the cause and, if it’s due to an oral condition, develop a treatment plan to help eliminate it.
What you eat affects the air you exhale. Certain foods, such as garlic and onions, contribute to objectionable breath odor. Once the food is absorbed into the bloodstream, it is transferred to the lungs, where it is expelled. Brushing, flossing and mouthwash will only mask the odor temporarily. Odors continue until the body eliminates the food. Dieters may develop unpleasant breath from infrequent eating.
If you don’t brush and floss daily, particles of food remain in the mouth, collecting bacteria, which can cause bad breath. Food that collects between the teeth, on the tongue and around the gums can rot, leaving an unpleasant odor.