value based dental practice
DESCRIPTION
PresentationTRANSCRIPT
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The Exceptional Patient Experience T h e Va l u e s B a s e d D e n t a l P r a c t i c e
William T. Brown, D.D.S.
Friday, February 22, 13
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Introductions
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Introductions
Introduce yourself and
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Introductions
Introduce yourself and
What influenced you to go into the Dental Profession?
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Bill Brown
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Bill BrownWho am I?
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Bill BrownWho am I?
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Bill BrownWho am I?
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Steps in achieving workshop goals:
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Steps in achieving workshop goals:
“IS”
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Steps in achieving workshop goals:
“IS”
“WAS”
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Steps in achieving workshop goals:
“IS”
“WAS”
“MIGHT BE”
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My Goal is that Each of You Will:
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My Goal is that Each of You Will:
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My Goal is that Each of You Will:
Identify some change you want to make
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My Goal is that Each of You Will:
Identify some change you want to make
Understand COHC
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My Goal is that Each of You Will:
Identify some change you want to make
Understand COHC
Develop & use your philosophy as a communication tool.
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My Goal is that Each of You Will:
Identify some change you want to make
Understand COHC
Develop & use your philosophy as a communication tool.
Conduct exams that influence attitudes & monitor oral health.
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My Goal is that Each of You Will:
Identify some change you want to make
Understand COHC
Develop & use your philosophy as a communication tool.
Conduct exams that influence attitudes & monitor oral health.
Have you leave with an idea of your next step.
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BRAINSTORMING
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BRAINSTORMING
For Change:
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Change
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Change
“Everyone thinks of changing the world, but no one thinks of changing himself.” - Leo Tolstoy.
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An EXPERIMENTAL ATTITUDE
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Key Elements:
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Key Elements:
Core Beliefs that are understandable & repeatable by staff & patients.
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Key Elements:
Core Beliefs that are understandable & repeatable by staff & patients.
Establishing Effective Doctor-Patient Relationship.
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Key Elements:
Core Beliefs that are understandable & repeatable by staff & patients.
Establishing Effective Doctor-Patient Relationship.
Involving Patients in a Health Story.
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Key Elements:
Core Beliefs that are understandable & repeatable by staff & patients.
Establishing Effective Doctor-Patient Relationship.
Involving Patients in a Health Story.
Dental Metrics to Monitor Patient Progress.
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A Personal Story
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A Personal Story
Diagnosed with gingivitis at age 28
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A Personal Story
Diagnosed with gingivitis at age 28
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A Personal Story
Diagnosed with gingivitis at age 28
I was shocked!
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I thought I had a healthy mouth
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A Personal Story
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I thought I had a healthy mouthThis revelation caused me to change
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A Personal Story
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I thought I had a healthy mouthThis revelation caused me to change I needed to find the cause
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A Personal Story
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From My Own Life,My Conclusions:
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From My Own Life,My Conclusions:
Interruption of a disease process
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From My Own Life,My Conclusions:
Interruption of a disease process
Patients were responsible for their oral health
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From My Own Life,My Conclusions:
Interruption of a disease process
Patients were responsible for their oral health
And not “Objects of Treatment”
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From My Own Life,My Conclusions:
Interruption of a disease process
Patients were responsible for their oral health
And not “Objects of Treatment”
NEW SYSTEMS NEEDED
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The Result of My Learning & Influences”
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The Result of My Learning & Influences”
c o m p r e h e n s i v e o r a l h e a l t h c a r e
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Knowledge is Empowering
Critical Issue
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Studied causes of my problem
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Studied causes of my problem
Bacterial plaques
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Studied causes of my problem
Bacterial plaques
Mechanical removal
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Studied causes of my problem
Bacterial plaques
Mechanical removal
Unmanageable areas manageable
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Studied causes of my problem
Bacterial plaques
Mechanical removal
Unmanageable areas manageable
The cause of man’s most common disease was bacterial plaques
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Dr. C.C. Bass
Dr. C.C. Bass in his dental laboratory
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Bacteria settle on the teeth and organizes to cause disease
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What He Found Out:
Dr. C.C. Bass in his dental laboratory
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I incorporated the Bass techniques personally, and my periodontal disease was controlled in less than a month
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Dr. C.C. Bass
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I incorporated the Bass techniques personally, and my periodontal disease was controlled in less than a month
This personal experience and epiphany was a revelation that I knew I had to share with my patients
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Dr. C.C. Bass
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Comprehensive Oral Health Care
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Comprehensive Oral Health Care
Resulted from experience & influences
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Comprehensive Oral Health Care
Resulted from experience & influences
Dentistry is a dynamic evolving science
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Comprehensive Oral Health Care
Resulted from experience & influences
Dentistry is a dynamic evolving science
Shift from techniques to dental team
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The Five Components of COHC
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The Five Components of COHC
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humanistic
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The Five Components of COHC
Humanistic
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The Five Components of COHC
Humanistic- Importance of patient involvement in oral health care
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The Five Components of COHC
Humanistic- Importance of patient involvement in oral health care
- What a patient does every day is more important than what is done in the dental office two or more times a year
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The Five Components of COHC
Humanistic- Importance of patient involvement in oral health care
- What a patient does every day is more important than what is done in the dental office two or more times a year
- Avoid treating patients as objects
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The Five Components of COHC
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humanistic
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The Five Components of COHC
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humanistic
biologic
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The Five Components of COHC
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Biologic
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The Five Components of COHC
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Biologic- Understand basic biology
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The Five Components of COHC
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Biologic- Understand basic biology
- Oral Cavity-Organ System
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The Five Components of COHC
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Health Plans Expand Dental BenefitsStudies Linking Gum Disease To Health Problems Spur New Focus on Preventive Treatments
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The Future
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The Future
Picture a world where dentists are the entry point in the health care system.
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The Future
Picture a world where dentists are the entry point in the health care system.
Relationships between Perio Disease and :
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The Future
Picture a world where dentists are the entry point in the health care system.
Relationships between Perio Disease and :
• CV Disease
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The Future
Picture a world where dentists are the entry point in the health care system.
Relationships between Perio Disease and :
• CV Disease
• Diabetes
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The Future
Picture a world where dentists are the entry point in the health care system.
Relationships between Perio Disease and :
• CV Disease
• Diabetes
• Pre-Term and/or Low Birth Weight Babies
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The Future
Picture a world where dentists are the entry point in the health care system.
Relationships between Perio Disease and :
• CV Disease
• Diabetes
• Pre-Term and/or Low Birth Weight Babies
• Salivary Diagnosis
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The Five Components of COHC
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humanistic
biologic
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The Five Components of COHC
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humanistic
biologic
diagnostic
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Diagnosis
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Diagnosis
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Diagnosis is the reason for professional education
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Diagnosis
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Diagnosis is the reason for professional education
Diagnosis is based upon COE
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Diagnosis
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Diagnosis is the reason for professional education
Diagnosis is based upon COE
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The Five Components of COHC
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humanistic
biologic
diagnostic
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The Five Components of COHC
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humanistic
biologic
diagnostic
therapeutic
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The Five Components of COHC
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Therapeutic
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The Five Components of COHC
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Therapeutic
- Importance of providing the patient with comfort, function and a good appearance
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The Five Components of COHC
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Therapeutic
- Importance of providing the patient with comfort, function and a good appearance
- Therapy is based on the information gathered in the examination/diagnostic phase.
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The Five Components of COHC
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humanistic
biologic
diagnostic
therapeutic
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The Five Components of COHC
31
humanistic
biologic
diagnostic
therapeutic PHILOSOPHY
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Philosophy:
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Philosophy:
32
The “glue” that holds the components of COHC together
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Philosophy:
32
The “glue” that holds the components of COHC together
Used as a communication & management tool with staff and patients
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Philosophy:
32
The “glue” that holds the components of COHC together
Used as a communication & management tool with staff and patients
- Should be easy to explain & repeatable by patients & staff.
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Philosophy:
32
The “glue” that holds the components of COHC together
Used as a communication & management tool with staff and patients
- Should be easy to explain & repeatable by patients & staff.
- Can be a roadmap.
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Comprehensive Oral Examination
PHILOSOPHY
c o m p r e h e n s i v e o r a l e x a m i n a t i o n
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34
This is NORMAL
The Gold Standard!
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Bleeding Is Not Normal
This is average, but not normal
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36
Comprehensive Oral Examination
System development
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36
Comprehensive Oral Examination
System development
- COE
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36
Comprehensive Oral Examination
System development
- COE
- Baseline data
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36
Comprehensive Oral Examination
System development
- COE
- Baseline data
- Quantify monitoring progress
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37
Comprehensive Oral Examination
Benefits
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37
Comprehensive Oral Examination
Benefits
- Involves patient in a HEALTH STORY
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37
Comprehensive Oral Examination
Benefits
- Involves patient in a HEALTH STORY
- COE is what’s best for your patients
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37
Comprehensive Oral Examination
Benefits
- Involves patient in a HEALTH STORY
- COE is what’s best for your patients
- COE is a powerful non-verbal communication tool you’re thorough
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37
Comprehensive Oral Examination
Benefits
- Involves patient in a HEALTH STORY
- COE is what’s best for your patients
- COE is a powerful non-verbal communication tool you’re thorough
- Co-Dx can break the “preoccupation barrier”
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37
Comprehensive Oral Examination
Benefits
- Involves patient in a HEALTH STORY
- COE is what’s best for your patients
- COE is a powerful non-verbal communication tool you’re thorough
- Co-Dx can break the “preoccupation barrier”
- Check list - Don’t land with wheels up! Friday, February 22, 13
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38
Comprehensive Oral Examination
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Additional benefit: what’s best for the patient
38
Comprehensive Oral Examination
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Additional benefit: what’s best for the patient
What would you do for a member of your family?
38
Comprehensive Oral Examination
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39
Comprehensive Oral Examination
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Additional benefit
39
Comprehensive Oral Examination
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Additional benefit
- Change in dentist’s image
39
Comprehensive Oral Examination
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40
Comprehensive Oral Examination
Yields benefits to patient and practitioner
c o m p r e h e n s i v e o r a l e x a m i n a t i o n
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40
Comprehensive Oral Examination
Yields benefits to patient and practitioner
A powerful nonverbal communication of your sincere desire to be thorough and complete in your procedures
c o m p r e h e n s i v e o r a l e x a m i n a t i o n
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Comprehensive Oral Examination
Instantly communicates to your patient that your practice is exceptional
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41
Comprehensive Oral Examination
Instantly communicates to your patient that your practice is exceptional
Establishes a new rapport
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42
Comprehensive Oral Examination
Is the only method:
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42
Comprehensive Oral Examination
Is the only method:
- To find all the patient’s needs
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Comprehensive Oral Examination
Is the only method:
- To find all the patient’s needs
- Dentist’s moral, legal obligation, and responsibility
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43
Comprehensive Oral Examination
Can you imagine a physician’s Physical Exam:
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43
Comprehensive Oral Examination
Can you imagine a physician’s Physical Exam:
Without measuring blood pressure
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43
Comprehensive Oral Examination
Can you imagine a physician’s Physical Exam:
Without measuring blood pressure
- Without weighing you
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43
Comprehensive Oral Examination
Can you imagine a physician’s Physical Exam:
Without measuring blood pressure
- Without weighing you
- Or listening to your heart and lungs
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43
Comprehensive Oral Examination
Can you imagine a physician’s Physical Exam:
Without measuring blood pressure
- Without weighing you
- Or listening to your heart and lungs
Preposterous for “RD” to perform the above procedures, but not record them
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44
Comprehensive Oral Examination
As many procedures as there are dentists
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44
Comprehensive Oral Examination
As many procedures as there are dentists
- My procedure evolved over many years
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44
Comprehensive Oral Examination
As many procedures as there are dentists
- My procedure evolved over many years
- You decide what might work for you
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Comprehensive Oral Examination
As many procedures as there are dentists
- My procedure evolved over many years
- You decide what might work for you
- My COE can serve as a matrix or outline
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44
Comprehensive Oral Examination
As many procedures as there are dentists
- My procedure evolved over many years
- You decide what might work for you
- My COE can serve as a matrix or outline
- COE is culmination of many different sources
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With COE:
Baseline data allows us to determine patient progress.
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46
Comprehensive Oral Examination
Barkley, Kohn, and Burns
Dr. Robert Barkley, DDS
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Elements of COE
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Elements of COE
Orientation
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Elements of COE
Orientation
Clinical
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Elements of COE
Orientation
Clinical
Radiographic/Digital (CBCT?)
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Elements of COE
Orientation
Clinical
Radiographic/Digital (CBCT?)
Treatment planning
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Elements of COE
Orientation
Clinical
Radiographic/Digital (CBCT?)
Treatment planning
Consultation
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Elements of COE - Orientation
48
Medical / DentalHistory
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Elements of COE - Orientation
49
Non-ThreateningEnvironment
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Elements of COE - Orientation
49
You are what the patient experiences
Non-ThreateningEnvironment
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Elements of COE - Orientation
50
Interview
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Elements of COE - Orientation
51
Philosophical Agreement
- not byacquiescence
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Elements of COE - Orientation
52
PatternedInterview
How can I help you? _______________________________________________________Review medical history. ___________________________________________________Age of first dental appointment. ___________________________________________Any history of bad experiences. ___________________________________________Was care regular? __________ How much care was needed?__________________Are parents living? _______________________________________________________What is parents’ dental condition and care habits? Edentulous? _____________What is / was brothers’ / sisters’ dental condition and care habits? Edentulous? ________________________What is / was spouse’s dental condition and care habits? Edentulous? ______________________________What is / was children’s dental condition and care habits? Edentulous? __________________________________How would you describe your present dental health? Good Fair PoorWhat has the past five years’ care been? ____________________________________Do you think your dental disease is active or controlled? ____________________Have you been taught to control it? ________________________________________How do you feel about ever losing your teeth? ______________________________Two main goals of practice? _______________________________________________Any problems to handle today? ____________________________________________
Orientation - Dental History
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Elements of COE - Orientation
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Mantra for new patients
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Elements of COE - Orientation
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Mantra for new patients
“We have unconditional amnesty for dentist evaders.”
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Elements of COE - Orientation
Specific comments:
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Elements of COE - Orientation
Specific comments:
- How can I help you?
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Elements of COE - Orientation
Specific comments:
- How can I help you?
- Review medical history.
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Elements of COE - Orientation
Specific comments:
- How can I help you?
- Review medical history.
- Age of first dental appointment.
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Elements of COE - Orientation
Specific comments:
- How can I help you?
- Review medical history.
- Age of first dental appointment.
- Any history of bad experiences?
54Friday, February 22, 13
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Elements of COE - Orientation
Specific comments:
- How can I help you?
- Review medical history.
- Age of first dental appointment.
- Any history of bad experiences?
- Was your care regular? How much was needed?
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Elements of COE - Orientation
Specific comments:
- How can I help you?
- Review medical history.
- Age of first dental appointment.
- Any history of bad experiences?
- Was your care regular? How much was needed?
- Are your parents living? Parents dental conditions & habits? Edentulous?
54Friday, February 22, 13
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Elements of COE - Orientation
Specific comments:
- What is/was your brother’/sisters’ dental condition & care habits? Edentulous?
55Friday, February 22, 13
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Elements of COE - Orientation
Specific comments:
- What is/was your brother’/sisters’ dental condition & care habits? Edentulous?
- What is/was your spouses’ dental condition & care habits? Edentulous?
55Friday, February 22, 13
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Elements of COE - Orientation
Specific comments:
- What is/was your brother’/sisters’ dental condition & care habits? Edentulous?
- What is/was your spouses’ dental condition & care habits? Edentulous?
- What are your children’s dental condition & care habits? Edentulous?
55Friday, February 22, 13
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Elements of COE - Orientation
Specific comments:
- How would you describe your present dental health? Good, Fair, Poor?
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Elements of COE - Orientation
Specific comments:
- How would you describe your present dental health? Good, Fair, Poor?
- What has the last five years’ care been?
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Elements of COE - Orientation
Specific comments:
- How would you describe your present dental health? Good, Fair, Poor?
- What has the last five years’ care been?
- Do you think your dental disease is active or controlled?
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Elements of COE - Orientation
Specific comments:
- How would you describe your present dental health? Good, Fair, Poor?
- What has the last five years’ care been?
- Do you think your dental disease is active or controlled?
- Have you ever been taught to control it?
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Elements of COE - Orientation
Specific comments:
- How would you describe your present dental health? Good, Fair, Poor?
- What has the last five years’ care been?
- Do you think your dental disease is active or controlled?
- Have you ever been taught to control it?
- How do you feel about ever losing your teeth?
56Friday, February 22, 13
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Elements of COE - Orientation
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Elements of COE - Orientation
57
CRITICAL POINT
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Elements of COE - Orientation
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Two main goals of practice:
CRITICAL POINT
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Two main goals of practice:1. Never lose your teeth.
CRITICAL POINT
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Elements of COE - Orientation
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Two main goals of practice:1. Never lose your teeth.2. Ultimately lower the incidence
of dental repair
CRITICAL POINT
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Elements of COE - Orientation
Orientation accomplishes:
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Elements of COE - Orientation
Orientation accomplishes:
- Agreement on the basics before proceeding - not by acquiescence
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Elements of COE - Orientation
Orientation accomplishes:
- Agreement on the basics before proceeding - not by acquiescence
- Establish common reference point - agree philosophically
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Elements of COE - Orientation
Orientation accomplishes:
- Agreement on the basics before proceeding - not by acquiescence
- Establish common reference point - agree philosophically
- New doctor patient relationship
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Elements of COE - Orientation
Orientation accomplishes:
- Agreement on the basics before proceeding - not by acquiescence
- Establish common reference point - agree philosophically
- New doctor patient relationship
- Personal dental health awareness
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Elements of COE - Orientation
Orientation accomplishes:
- Agreement on the basics before proceeding - not by acquiescence
- Establish common reference point - agree philosophically
- New doctor patient relationship
- Personal dental health awareness
- New insight and understanding
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Elements of COE - Orientation
59
Establish a Relationship
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Elements of COE - Radiographic/Digital
60
Digital Radiographs, Digital Images
and Models
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Co-Discovery
61
Digital Imaging for Co-diagnosis
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Clinical
62
Co-diagnosis
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Elements of COE - Clinical
63
Exam Form
Dental
Record on the tooth chart.
Missing teeth, why lost, position of remaining teeth and replacements No. ________________________________________________
Chart all other variations from normal, (see symbol sheet)
Palpation over the gingiva and roots of the teeth to determine bone form _______________________________________________________
Extension of the lips and cheeks for the observation of frena and muscle attachments, position of the gingival margin, and width of the attached gingiva.
Probe for pocket depth and furcation involvement.
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Elements of COE - Clinical
64
Son of a Dentist
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Elements of COE - Clinical
65
Attached Gingiva
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Elements of COE - Clinical
66
Attached Gingiva
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Elements of COE - Clinical
67
Dental Form
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Elements of COE - Clinical
68
Soft Tissue
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Elements of COE - Clinical
69
Buccal Mucosa
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Elements of COE - Clinical
70
Examination Form
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Elements of COE - Clinical
71
TMJ (Temporo- mandibular Joint)
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Elements of COE - Clinical
72
Exam Form
Occlusion 0 - none 1 - slight 2 - moderate 3 - extensive
___ Premature centric contacts No. __________________________
___ Biting stress mobility No. _______________________________
___ Right working contacts No. ______________________________
___ Right (left) non-working No. _____________________________
___ Left working contacts No. _______________________________
___ Left (right) non-working No. _____________________________
___ Protrusive contacts No. ________________________________
___ Right dec. chewing efficiency ____________________________
___ Left dec. chewing efficiency _____________________________
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Elements of COE - Clinical
73
Non-Working Interferences
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Elements of COE - Clinical
74
Occlusion
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Elements of COE - Clinical
75
Exam Form
Habit Signs 0 - none 1 - slight 2 - moderate 3 - extensive
Tongue ThrustTongue ThrustReverse swallowingLateral indentationsFungifuorm enlarge
BruxismBruxismFacetingOcclusal wearHyper masseter
MouthbreathingMouthbreathingLack of nasal flareGingival changesNail biting
TemporomandibularTemporomandibularRight painRight crepitusLeft painLeft crepitus
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Elements of COE - Clinical
76
AmelogenesisImperfecta
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Elements of COE - Clinical
77
Tooth Mobility
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Elements of COE - Clinical
78
Periodontal Pocket Depth
Probing
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Elements of COE - Clinical
79
Periodontal Pocket Depth
Probing
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Elements of COE - Clinical
80
Probing in Six Places
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Elements of COE - Clinical
81
Why periodontal disease can’t be diagnosed with x-ray only
Cadaver
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Elements of COE - Clinical
82
Cadaver Lingual View
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Enamel Projection
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Enamel projection
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Elements of COE - Treatment Planning
85
Exam Form
Complete the remainder of the form after the patient is dismissed.
General condition of mouth ___________________________________
State of active disease
Caries _____________________________________________________
Perio _____________________________________________________
State of bacterial control _____________________________________
State of manageability _______________________________________
Pt’s attitude during exam - Interested Casual Disinterested
Fears and dislikes of potential treatment possibilities _____________________________________________________________
Hope and desires about future dentistry ______________________
_____________________________________________________________
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Elements of COE - Treatment Planning
86
Initial Status
FacialFacialFacial
1-5 6-11 12-16TEETH NO.
CALCULUS
BLEEDING
SUPPURATION
GINGIVAL TEXTURE
GINGIVAL FORM
EXTOSTOSES
PLAQUE (DEBRIS)
PalatalPalatalPalatal
16-12 11-6 5-1
FacialFacialFacial
17-21 22-27 28-32
LingualLingualLingual
32-28 27-22 21-17
Mean
Date TM Occl Sul Ging Perio Calc Debris Irritant
INITIAL
RE-EVALUATION
SIX MONTH
ONE YEAR
TWO YEAR
THREE YEAR
Etiology ______________________________________________________________________________
Diagnosis _________________________________________________________________________
Prognosis __________________________________________________________________________
Treat Plan _________________________________________________________________________
__________________________________________________________________________________
Initial Status
Patient Status
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Section 1. First appointment. (Orientation)Observations about patient.
Section 2. Second appointment. (Examination)Summarize medical history (questions 1-55)Additional dental history information obtained during examinationSummarize dental history (questions 56-105)Basic physical findingsSummarize diet history (questions 106-115)Synopsis of historical findings
Section 3. Oral ExaminationComplete soft tissue examination (quanitate changes 0-3)Complete occlusal examination (quanitate)Habit evaluationReview of radiograph findingsDental examination (complete charting of all restorative and periodontal needs - absolutely must probe all pockets)
Section 4. Review of findingsQuantitation of the periodontal condition at initial examination. Quantitation of periodontal findings with progression of treatmentTM - Tooth Mobility; Occl - Occlusion; Sul-Pocket Depths; Ging - Gingival Status; Perio is average of means of TM, Occl, Sul, GingCalc - Calculus; Debris - plaque; irritant is average of calc, debris
Elements of COE - Treatment Planning
87
Explanation of Examination
Forms
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Elements of COE - Treatment Planning
88
Initial Status with Numbers
from Exam
FacialFacialFacial
1-5 6-11 12-16
2 1 23 2 21 0 12 2 22 2 20 0 02-3 3 3
TEETH NO.
CALCULUS
BLEEDING
SUPPURATION
GINGIVAL TEXTURE
GINGIVAL FORM
EXTOSTOSES
PLAQUE (DEBRIS)
PalatalPalatalPalatal
16-12 11-6 5-1
2 1 22 2 21 0 11 2 11 2 11 0 13 3 3
FacialFacialFacial
17-21 22-27 28-32
1 2 12 3 20 1 02 3 22 3 20 0 03 2 3
LingualLingualLingual
32-28 27-22 21-17
2 2-3 23 2 31 0 12 2 22 2 20 0 03 3 3
Mean
Date TM Occl Sul Ging Perio Calc Debris Irritant
1 2 2.6 2 1.9 1.7 2.9 1.8INITIAL
RE-EVALUATION
SIX MONTH
ONE YEAR
TWO YEAR
THREE YEAR
Etiology ______________________________________________________________________________
Diagnosis _________________________________________________________________________
Prognosis __________________________________________________________________________
Treat Plan _________________________________________________________________________
__________________________________________________________________________________
Initial Status
Patient Status
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Elements of COE - Treatment Planning
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Explanation of Assessing Periodontal
Status: Quantization of
Periodontal Condition at
Initial Examination
SCORING CALCULUS
Score 3Score 2Score 1Score 0
heavy calculus (supra sub)moderate calculus (mainly sub)slight calculus (mainly supra)none
SCORING BLEEDING
Score 3Score 2Score 1Score 0
bleeds easily with probingbleeds moderately with probingbleeds slightly with probingnone
SCORING SUPPURATION
Score 3Score 2Score 1Score 0
pus readily appears with probingpus moderately appears with probingpus slightly appears with probingnone
SCORING GINGIVAL TEXTURE
Score 3Score 2Score 1Score 0
considerable swellingmoderate swellingslight swellingnormal
SCORING GINGIVAL FORM
Score 3Score 2Score 1Score 0
considerable enlargement alterationmoderate enlargement alterationslight enlargement alterationnormal
SCORING EXOSTOSIS
Score 3Score 2Score 1Score 0
considerable exostosismoderate exostosisslight exostosisnone
SCORING PLAQUE (DEBRIS)
Score 3Score 2Score 1Score 0
most of tooth coveredabout 1/3/ of tooth coveredless that 1/3 of tooth coverednone
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90
Elements of COE - Treatment Planning
Simple or complex
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90
Elements of COE - Treatment Planning
Simple or complex
Departure from normal
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90
Elements of COE - Treatment Planning
Simple or complex
Departure from normal
We see mostly “average” not normal
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90
Elements of COE - Treatment Planning
Simple or complex
Departure from normal
We see mostly “average” not normal
Complex may require “team approach”
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Patients comment:
“Do you do this for everyone?”
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Elements of COE - Treatment Planning
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Radiographic Exam
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Elements of COE - Treatment Planning
93
Case Planning
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Digital Metrics for COHC
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DentMet Excel Spreadsheet
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Digitizing Dental Metrics
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Digitizing Dental Metrics
• Code can be written in Microsoft Visual Basic
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Digitizing Dental Metrics
• Code can be written in Microsoft Visual Basic
• Metrics can be coded with oral commands through voice activation module
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Digitizing Dental Metrics
• Code can be written in Microsoft Visual Basic
• Metrics can be coded with oral commands through voice activation module
• Dental metrics can be statistically analyzed for an overall sum of patient’s health
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Digitizing Dental Metrics
• Code can be written in Microsoft Visual Basic
• Metrics can be coded with oral commands through voice activation module
• Dental metrics can be statistically analyzed for an overall sum of patient’s health
• Dental metrics can be linked to existing practice management software
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Potential Digital Metric Partners
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Potential Digital Metric Partners
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Potential Digital Metric Partners
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Potential Digital Metric Partners
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Potential Digital Metric Partners
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Potential Digital Metric Partners
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Elements of COE - Treatment Planning
98
Digital Images and Models
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Elements of COE - Consultation
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Consultation Can:
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Consultation Can:
Allow you to stop feeling you have to badger people into accepting treatment.
100Friday, February 22, 13
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Consultation Can:
Allow you to stop feeling you have to badger people into accepting treatment.
Help you find out what the person wants in a dentist
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Consultation Can:
Allow you to stop feeling you have to badger people into accepting treatment.
Help you find out what the person wants in a dentist
Find out what the person dreads about dentistry.
100Friday, February 22, 13
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Consultation Can:
Allow you to stop feeling you have to badger people into accepting treatment.
Help you find out what the person wants in a dentist
Find out what the person dreads about dentistry.
Help you replace resistance with collaboration.
100Friday, February 22, 13
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Consultation Can:
Allow you to stop feeling you have to badger people into accepting treatment.
Help you find out what the person wants in a dentist
Find out what the person dreads about dentistry.
Help you replace resistance with collaboration.
Keep you from feeling like a salesman.
100Friday, February 22, 13
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Consultation Can:
Allow you to stop feeling you have to badger people into accepting treatment.
Help you find out what the person wants in a dentist
Find out what the person dreads about dentistry.
Help you replace resistance with collaboration.
Keep you from feeling like a salesman.
Allow you to have a productive conversation about the patient’s wants and needs.
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Consultation IS:
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Consultation IS:
Based upon COE & Diagnosis
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Consultation IS:
Based upon COE & Diagnosis
The highest productivity of the Dentist
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Consultation IS:
Based upon COE & Diagnosis
The highest productivity of the Dentist
A critical issue for the patient
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Consultation IS:
Based upon COE & Diagnosis
The highest productivity of the Dentist
A critical issue for the patient
Variable (Simple, Complex, etc.)
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Consultation IS:
Based upon COE & Diagnosis
The highest productivity of the Dentist
A critical issue for the patient
Variable (Simple, Complex, etc.)
Not a “batting average”
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Consultation IS:
Based upon COE & Diagnosis
The highest productivity of the Dentist
A critical issue for the patient
Variable (Simple, Complex, etc.)
Not a “batting average”
The embodiment of your practice philosophy
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102
Summary of COE
c o m p r e h e n s i v e o r a l e x a m i n a t i o n
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102
Summary of COE
How COE can solve problems
c o m p r e h e n s i v e o r a l e x a m i n a t i o n
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102
Summary of COE
How COE can solve problems
Make money (can only treat what you know to look for and find)
c o m p r e h e n s i v e o r a l e x a m i n a t i o n
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102
Summary of COE
How COE can solve problems
Make money (can only treat what you know to look for and find)
Stay out of trouble
c o m p r e h e n s i v e o r a l e x a m i n a t i o n
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102
Summary of COE
How COE can solve problems
Make money (can only treat what you know to look for and find)
Stay out of trouble
Do what’s best for your patients
c o m p r e h e n s i v e o r a l e x a m i n a t i o n
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Patient Who Did Her Own Surgery”
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After Meticulous Home Care:
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Before Plaque Control
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Two Weeks Later
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Disease Processes Differ
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The Mount Rushmore of Dentistry
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The Mount Rushmore of Dentistry
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The Mount Rushmore of Dentistry
108
• G.V. Black
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The Mount Rushmore of Dentistry
108
• G.V. Black
• C.C. Bass
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The Mount Rushmore of Dentistry
108
• G.V. Black
• C.C. Bass
• Robt. Barkley
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The Mount Rushmore of Dentistry
108
• G.V. Black
• C.C. Bass
• Robt. Barkley
• Sumter Arnim
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The Mount Rushmore of Dentistry
108
• G.V. Black
• C.C. Bass
• Robt. Barkley
• Sumter Arnim
• Per Branemark
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The Mount Rushmore of Dentistry
108
• G.V. Black
• C.C. Bass
• Robt. Barkley
• Sumter Arnim
• Per Branemark
• Michael Buoncore
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The Mount Rushmore of Dentistry
108
• G.V. Black
• C.C. Bass
• Robt. Barkley
• Sumter Arnim
• Per Branemark
• Michael Buoncore
• Dr. Bob Margeas
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109
What changes do I want to make?
How do I make them?
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What You Want:
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What You Want:
LIST FOUR THINGS YOU WANT YOUR PATIENTS
& STAFF TO SAY, BELIEVE, FEEL ABOUT YOU AS
A DENTIST AND YOUR DENTAL PRACTICE.
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111
Extensions for successful change
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111
Extensions for successful change
Control your own oral disease, if you haven’t already.
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111
Extensions for successful change
Control your own oral disease, if you haven’t already.
Require your office staff to have their oral disease under control.
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111
Extensions for successful change
Control your own oral disease, if you haven’t already.
Require your office staff to have their oral disease under control.
Develop an examination form which includes components that you feel are necessary to accomplish COHC.
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111
Extensions for successful change
Control your own oral disease, if you haven’t already.
Require your office staff to have their oral disease under control.
Develop an examination form which includes components that you feel are necessary to accomplish COHC.
With a colleague, conduct a thorough examination on one another.
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112
Extensions for successful change
Conduct a thorough exam on a few selected patients (family, staff, patients) and solicit their reaction.
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112
Extensions for successful change
Conduct a thorough exam on a few selected patients (family, staff, patients) and solicit their reaction.
Write your philosophy of oral health care and share it verbally with your staff. Solicit their reaction.
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112
Extensions for successful change
Conduct a thorough exam on a few selected patients (family, staff, patients) and solicit their reaction.
Write your philosophy of oral health care and share it verbally with your staff. Solicit their reaction.
Solicit the oral health care philosophy of your staff. Is it the same as yours?
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112
Extensions for successful change
Conduct a thorough exam on a few selected patients (family, staff, patients) and solicit their reaction.
Write your philosophy of oral health care and share it verbally with your staff. Solicit their reaction.
Solicit the oral health care philosophy of your staff. Is it the same as yours?
Review patient records to see if you can make specific observations on patient progress.
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113
Extensions for successful change
Provide a small, select number of patients with a written and (or) verbal diagnosis. Solicit their reaction.
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113
Extensions for successful change
Provide a small, select number of patients with a written and (or) verbal diagnosis. Solicit their reaction.
Analyze with your staff the ways that your office and dental practices contribute to changing the dental behaviors of patients.
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113
Extensions for successful change
Provide a small, select number of patients with a written and (or) verbal diagnosis. Solicit their reaction.
Analyze with your staff the ways that your office and dental practices contribute to changing the dental behaviors of patients.
Discuss the ideas shared here, and get their reactions.
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114
You’ve Been Shown:
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114
You’ve Been Shown:
How systems were developed.
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114
You’ve Been Shown:
How systems were developed.
And how you can develop you own unique program.
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114
You’ve Been Shown:
How systems were developed.
And how you can develop you own unique program.
My system isn’t perfect.
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114
You’ve Been Shown:
How systems were developed.
And how you can develop you own unique program.
My system isn’t perfect.
Your system will have shortcomings.
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You’ve Been Shown:
How systems were developed.
And how you can develop you own unique program.
My system isn’t perfect.
Your system will have shortcomings.
The process will enhance your goal
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Comprehensive Oral Health CareT H E G O A L O F D E N T I S T RY
Q & A
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Patient Communications
need a section on pt. relations: Green Notes, office satisfaction surveys, mystery patient, staff feedback, focus groups, cleanliness (office, staff, Doctor) e.g. spots on glasses, blood spatters on gowns, breath odor, personal grooming.
The car you drive and How you drive it.
The way you dress.
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