Prevention-Centered Success: A Win for the Dental Team, the Patient and the Practice

You're listening to The Dr. Phil Klein Dental Podcast from Viva Learning.com. Welcome to the show. I'm Dr. Phil Klein. Today's dental patients are hungry for prevention strategies that work and lead to less need for restorative care. Long gone are the days when dental practices focus solely on the challenge of restoring decayed dentition. Today we'll be discussing how utilizing a caries risk assessment strategy for preventing or reversing early stage dental caries is evidence-based. and creates a win-win for patients and the dental practice alike our guest is Dr Jean Creasey a practicing dentist for over twenty years in northern California with a focus on prevention and minimally invasive dentistry she is currently an academic consultant at california north stars college of dental medicine where she teaches ethics and professionalism before we get started i would like to mention that dr creasy's webinar titled prevention centered success is now available as an on-demand webinar on VivaLearning.com. Simply type in the search field Creasey , C-R-E-A-S-E-Y, and you'll see it. It's an excellent webinar for every dental team member to watch, so I highly recommend it. Dr. Creasey is a great speaker. Dr. Creasey , it's a pleasure to have you back on Dental Talk. Thank you, Phil. It's a pleasure to be back here. I had a lot of fun doing that recent webinar for Viva Learning, and so it's a pleasure to talk more about prevention. Yeah, and you had a great turnout. as you have in the past. And it's hard to believe it's two years already since our last podcast. It was just when COVID was starting to pick up steam. I think it was August of 2020. We had a really nice podcast, a similar topic. And today's talk, as the title mentions, is prevention-centered success, how focusing on carries prevention is a win-win-win. And we're talking about for the patients, providers, and the practice. So to begin, why is being a prevention-focused practice so important, and why is it in the best interest of the dentist and the practice? Well, for me, being prevention-focused has really been kind of the secret key to our success, I think. You might know that I started out my career in dentistry as a hygienist, so I really, from the get-go, I brought a prevention focus. And what I found is that being patient -centered, where you really focus on the unique risk factors that each patient has, it resonates with patients and they appreciate that sort of. individual approach to their health you're coaching them towards their unique best oral health possible and for each patient that might look like addressing different risk factors so um i found that it really helped build our practice because they don't hesitate to tell their friends when they have a dentist who they really feels like focuses on them as an individual I think it also helped me maintain my sanity through the years because it let me sleep well at night knowing that I had done everything I could for each patient. It wasn't just repairing. It wasn't fixing everything all the time. It was really addressing the cause of the disease. Do you think that your practice that's very focused on prevention stems from the fact that you were a hygienist in your past life? And do you think that in general, GPs are doing the same thing? there's been a culture shift within our profession. I think there's much more knowledge about understanding caries as a continuum. It's a disease that we would take care of a little bit like a physician might treat diabetes, that there's the prevention aspect. It's understanding the process. And again, if you just restore a carious lesion without addressing the disease factors and how it got to exist in the first place, you're not really addressing the problem. You're just putting your fingers in the dike until more decay happens. Yeah, without a doubt. So what can the dental team do to effectively encourage patients to make behavior changes that enhance their oral health? Well, I think having a team approach, I think there's been a lot of good... information disseminated in the profession and all the journals and that really helps but having a team approach where the dentist takes responsibility to explain to their staff, why are we doing this? Why is this important? Because if you rely on the education that your staff brings to the table, if somebody went to school 20 years ago, they might not be aware of the paradigm shift that's taken place in the profession. So it's really up to the dentist as the team leader to introduce the ideas of change and to implement those in a meaningful way. Can you give us an example of a discussion or a strategy that would take place in a dental office where the owner of the practice is meeting with his staff and saying, you know, we need to really start moving towards more of a prevention focused practice. I took a webinar from Dr. Creasey on VivaLearning.com and it completely motivated me to really introspectively look at our practice and see why we're not really taking that same approach. So what are some of the things specifically that dental practice owner can do? So I think from my own experience, what has worked well is to have a lunch and learn with your staff where you introduce the basic concepts of carries prevention and carries risk assessment to the whole team, not just the hygiene team, but your assistants, your front office managers, because to have everybody kind of bought into the science behind why does prevention work, it resonates with them both as individuals and then as dental team members. So you introduce the concepts. you go through it in a very straightforward way you so you're maybe sharing a powerpoint that you've downloaded from the internet you're looking at um so and then you're coming up with a list of practices that you want to take place within the dental office that you're going to how you're going to do the risk assessment who's going to be in charge of what you might even for a for a dental team the dentist would be probably more successful if they identified a couple of people to be leaders in this effort. In other words, you're kind of gaining the buy-in of influential members on your team beforehand. Most dental office staff have their own hierarchy of who listens to whom. And just because any group of human beings, that's sort of our natural behavior is that there might be influencers within your dental team. So identifying who those people are, getting their buy-in. And then another important step is to have something that you can measure, like keep track of how many patients you've introduced to using extra strength fluoride gel to brush their teeth or how many adults you've identified to apply fluoride varnish at three-month recall. These would be high-risk patients that you want to monitor. and keeping track of the metrics on those patients. How often did they receive the services? And then watching their outcomes, seeing the success of a prevention practice will fuel the energy of the team to keep implementing these changes as you go forward. Where is the metrics documented so that you could interpret what the results are of your efforts? Well, I've seen offices hang a chart in their staff room where they might put down the number of patients that they did a risk assessment form on each week. There are little metrics that you can look at just to give the team reinforcement that we're doing this. This is happening. It's not just something that's going on in our head. So maybe measuring the number of patients. that you did a risk assessment on each week and each month, who did them, the number of times you've introduced the idea of using extra strength fluoride gel to brush with, those kind of small things that you can easily keep track of and write on a chart that everybody sees. It's funny because dental offices historically used to track production quite readily. And not that there's anything wrong with that, but in a way, my philosophy would be to keep track more of the dental health that you're influencing than just the amount of production the office is making. Yeah. And like you said, having a very prevention focused practice really is a great marketing tool because patients understand that. They'll say, you know, this is really interesting because the last few dentists I went to, they were really focusing on. doing restorative work and more of high cost stuff right off the bat before we even got into like, what's the root cause of some of these problems I'm having? Of course, you have to do the restorative work if it's needed. But like you said, you don't want to be circling around and chasing it all the time if you're not getting to the prevention aspect of it. Yeah, I think innumerable patients over my career have sat up in the chair after I've had a talk with them and said, you know, you're the first person that's really gone into why this is happening and given me some tools. to control this disease process. So it makes you feel good as a professional. It also, I think, helps you enjoy better staff retention because I find that my staff likes working for a dentist who focuses on the patient's oral health as their top priority. Yeah, that is absolutely true. And if I was working for you, Dr. Creasey , I'd be proud to work for you because I love the culture of your practice. So we talked about fluoride treatment for adults. And offline, we talked about Centrix has a product called Floridose. Is there something about that that you prefer? Or is it just that that's what you ended up using in the past? Yeah, I like that it is a fluoride varnish that has a slow release of the fluoride. And I've read studies that have shown that that is a more effective way of delivering the fluoride in a product that has more of a slow, long release of the fluoride than just a quick release of the fluoride. And it only makes sense, the substantivity being higher. If it sticks around in the area, it's going to have a longer lasting effect. I like that. My patients don't complain about the taste. It's pretty easy to use. That tends to be my preference. If you want more information about that product, you can look it up online. The company is Centrix, C-E-N-T-R-I-X. The product is Floridos. What are your favorite takeaway prevention messages for patients, and how do you make sure they understand and remember them when they're seeing you in your practice? I try and keep a very lighthearted conversation with my patients when I talk to them about changing their own oral health behaviors. Because people don't like to make change, as we all know. If your physician tells you, you know, you better get out and... and go running more. You need to do more core strengthening exercises. It will help your back. Well, you have to be pretty motivated to make those changes. And it's no different for patients when we have them changing the way they approach their oral hygiene. So I like to use a lot of fun analogies to help them understand what's going on with their teeth. When I talk about demineralization, that's kind of a 25 cent word that many people don't have an image in their head of what you're talking about. And so I'll make a comparison, like imagine if your teeth were made out of bricks and we've all seen older buildings that were made out of bricks where the bricks are kind of crumbling. That's what your enamel is doing as it dissolves in an acid environment. your enamel is crumbling, it's dissolving. I use the expression that your teeth are melting in the acid that we create through a biofilm process. When I talk about the need to change the biofilm from acid producing bacteria. to fewer acid producing bacteria. I'll talk about growing your lawn and having weeds infiltrate. And the weeds would be analogous to acid producing bacteria. And obviously you don't want to feed the weeds by giving them fermentable carbohydrate all the time, sugary substances. I say things. that might catch them off guard like you know spit is one of your body's best friends you know like just things that they wouldn't normally hear that they might find worth remembering yeah the trick is to connect with your patients because if you use scientific words that may sound somewhat impressive as a doctor and they don't know what you're talking about nor can they connect to it they're going to block it out and they're not certainly not going to remember anything your goal is to get them to maintain a healthier diet a higher compliance home care regimen and make sure they come back to see you, whatever the regimen is in your office. So obviously that's the way to go. Well, that's good. Those are good tips. I think that's really important. And I think one of the most important things that you mentioned, I think in this podcast is just career satisfaction, building your practice based on the value system of really understanding the importance of prevention and not looking at these patients as, you know, let's treat all these things that are wrong with them. And as more things go wrong, let's continue to treat. That's the whole point of this podcast and what your webinar was. It's a win -win-win. Patients benefit, the dentist benefits, and overall the practice benefits. So these are really important things that you're bringing across in this podcast. Any closing remarks? No, just to piggyback off of what you've just said, I really feel like it does help prevent burnout among dentists, that if you approach it from this prevention-centered perspective, that it does give you more job satisfaction. That's really a key to our resilience and our ability to last a long time in the career of dentistry. Yeah, beautifully said. Thank you so much, Dr. Creasey. It's always great talking with you. And we need to have these podcasts more frequently than every two years. So we have to keep that in mind. Yeah, it was wonderful to see you and hear you again, Bill. Keep doing the good work you're doing to help spread the word of prevention and best practices in dentistry. I appreciate that. You have a great night. Thank you, Dr. Creasey.