Prevention is Profitable

You're listening to the Phil Klein Dental Podcast from VivaLearning.com. Thanks for joining us. I'm Dr. Phil Klein. Too often, clinical dental hygienists have a limited view of their role as what our guest calls inflammatory disease prevention specialists. While this is the crux of what hygienists do, patient care goes well beyond. Today, we'll be talking about the oral systemic link and how hygienists can leverage this. to add life -saving value to each patient they see and improve the profitability of their practice. Our guest is Alicia Murria, a quality care enthusiast, technology integration specialist, and productivity coach. She has devoted her career to empowering professionals to provide high -quality services utilizing the dental hygiene scope of practice as standard for care. Before we get started, I would like to mention that Alicia's webinar titled Prevention is Profitable will be coming up on VivaLearning.com on Wednesday, October 4th at 7 p.m. Eastern Time, 4 p.m. Pacific. So don't miss this important webinar on how to transform your hygiene practice and make it more profitable at the same time using a proactive preventative approach. Alicia, it's a pleasure to have you on Dental Talk. Thank you so much, Bill. So we're really happy to have you on here. I know you do a lot of lecturing. Did you coin that term or that name, inflammatory disease prevention specialist? Is that yours? I have coined that term. I have not heard anyone else using it since I've started using it in 2017. Okay, that's interesting. That's very cool. So to begin, let me use that term that you coined, which is pretty impressive. Tell us what an inflammation prevention specialist is. Well, an inflammation prevention specialist is any oral health care provider who has a focus on being more proactive rather than reactive. They offer opportunities to educate the patient and provide resources for the patient to be more proactive rather than reactive. We mostly know that dental hygienists are in a position to educate the patient and help them to prevent dental disease and also restorative treatments or restorative needs. But I don't believe the public sees us that way. So when we use the term inflammation prevention specialist, what it does is prevent... the oral health care provider as a health care provider. So if the inflammation prevention specialist role is prevention proactively, how does that affect the revenue of the practice? i'm so glad you asked that phil i have heard on several podcasts and even one of my colleagues rachel wall has been featured on several on several podcasts discussing the role of dental hygiene department and several leaders in the industry have discovered that the dental hygiene department has once been coined the last leader of the practice so when you consider prevention most dental practices don't invest in the dental hygiene department and that using technology or itemizing time to encourage patient education is not something that is really smiled upon. They look at advising more time in the hygiene department as a potential for loss. But when we consider the role of the inflammation prevention specialist, we're considering a professional who's not only going to educate the patient, but also offer recommendations from the practice standpoint that's going to build revenue or value to the practice. So as an example, an inflammation prevention specialist would be one who regularly creates or an opportunity to provide assessments for the patient. Assessments may look like periodontal charting, that may look like radiographic interpretation, that may also look like intraoral photographs or digital scanning. If the patient may suffer from some ailment that may prevent them from having a comfortable experience, the inflammation prevention specialist looks for opportunity to make the patient more comfortable and that may come with a profit margin. So with all those things considered, dental hygiene is no longer the loss leader when you look at it from an inflammation prevention specialist standpoint. So you're saying that the additional revenue that's created or generated from the assessments that you do, which is imaging assessments, radiographic assessments, that's all billable, you're saying? Yes, sir. And even the things that are not billable. So if you consider periodontal charting. or if you consider an intraoral photograph or an intraoral scan. These are things that are not billable, but what they do is add value to the dental hygiene appointment, and it also lays a foundation for the dental hygienist looking for opportunities to be proactive. So in the event the patient may have mild to moderate bone loss, the inflammation prevention specialist uses that as an opportunity to educate the patient on how do we further prevent bone loss. What can we do? What tools do I have in my toolbox or in this practice that can be afforded to this patient to help them to prevent having further dental disease? The same would be true in terms of crowding or a tooth that may have a micro fracture or a tooth that may even have recession and sensitivity. The inflammation prevention specialist, again, is looking for an opportunity to further engage the patient using those assessments, but also offering something within the hygiene appointment that's going to build revenue. Right. So those assessments kind of serve as a springboard for other treatments that would really help the patient proactively get ahead of what potentially could come later down the road if not taken care of, and that's all more dental treatment, which is better for the patient and better for the practice. For sure, for sure. And what you find most often in offices that find dental hygienists as the loss leaders, they're capitalizing on the shorter hygiene appointment, thinking that seeing more patients in the day is going to build more revenue. But if you see fewer patients and add more quality in that patient education aspect, you're going to build a better bond and also more opportunities for the clinician to get the patient to move forward with a more proactive approach to dentistry. And again, that makes everyone happy. You know, the clinician is... smarter and harder. The patient is receiving less dentistry. The doctor is doing more aesthetic and fun dentistry, not just the drill and field work. On a recent podcast that I did, I talked to someone who had a lot of expertise on wellness dentistry. And that also kind of started in the hygiene department. And that assessment aligns with what you're talking about here because of that oral systemic link and how you can get these patients to understand that what's happening in their mouth affects their whole body. And of course, you know, you can't ignore the fact that it's a great marketing tool. Word of mouth spreads like wildfire when you're teaching patients the things they need to do to keep their mouth healthy down the road to avoid expensive dental work and keep their natural teeth. Patients love that. They're going to tell their friends and that's a practice builder and there's another way to generate new revenue. So what assessments can be done specifically during the hygiene appointment? And you mentioned a few to maximize the value of the proactive approach and how can these assessments make the appointment more profitable? I can really appreciate you asking me that question, Phil. And I want to just outline just an example and a fun fact about me. Not only am I a public speaker and a practice coach and consultant, I also practice part-time as a clinician. And I do so on a fill-in basis. When I go in as a fill-in dental hygienist, I always went over the patient. And I do it simply by identifying opportunities to be more proactive. So an example of some things that we can do on a dental hygiene appointment, whether you know the patient for, you know, 10 or 15 years or it's your first time meeting them, one of the things that you can do is really just start with the patient's chief concern. And one of the things that we commonly hear in the dental hygiene appointment is, you know, please don't scale this area because it's sensitive or I have cold sensitivity. I can't eat the things that I want to eat or drink the things that I want. drink. So initially, the inflammation prevention specialist is going to address that chief concern. And with the sensitivity concern, what you want to do is ensure that the patient stays comfortable throughout the entire appointment. Using products like Vocos, Pro Fluorid L, is a great way to help to reduce some of that sensitivity and applying that right to the root surface and also light carrying it. So before you get started with scaling, the root surfaces are totally sealed off and the patient is not experiencing any discomfort. that appointment but in addition to that after you address the patient's chief concern what you will want to do is verify whether or not the patient is eligible for any type of assessment now if the patient is not due for radiographs that's a prime opportunity for us to employ other assessments most dental hygienists are going to say i don't have enough time in the appointment but i guarantee you if you look at it from the inflammation prevention specialist standpoint you will start to see that you do have time especially when the patient is not due for radiographs So when the patient's not doing her radiographs, this may be a great opportunity for us to take a photograph or intraoral scan of the patient's mouth or that area where they may be experiencing sensitivity. When we're looking at those areas after we have the updated intraoral photograph or the scan, now we're showing it to the patient, letting them know the etiology of the sensitivity. It's not because you brush your teeth too hard. It may be because your teeth are not in the proper position. So long term, if we do nothing, you're going to continue to wear down the gum tissue that's causing the sensitivity. And you're going to need something along the lines of a connective tissue graft. But as an inflammation prevention specialist, my role is to keep you from losing any more tooth structure. So I want to introduce you to different opportunities to save that tooth structure. That may be one and first and foremost, one, let's get you comfortable today. And that's using something like Pro Fluorid Ale. But secondly, let's put your teeth in a more upright position so you're no longer causing that destruction or harm. So now the dentist is coming in and talking to the inflammation prevention specialist. The conversation is not just, you know, we had a prophy and we applied some profloridale to that sensitive area. We're talking about long-term, more fun cosmetic dentistry. We can prevent further deterioration of the gum tissue and allow the patient an opportunity to do something along the lines of clear aligners. And again, as a temp dental hygienist, when I come in, I just talk to the patient about what do they know about sensitivity. And when they don't have any knowledge or foundation on sensitivity, that's where I use that as an opportunity to apply the assessments. And I show them where the teeth may be colliding and not sliding, how that may be causing the, you know, chipping of the microtubules and how that fluoride, that pro-fluorid L may cover those tubules and cause them to have less sensitivity today and for a few hours. It's going to happen again if we don't fix why it was happening in the first place. So that's the role of the inflammation prevention specialist and a great example of how you can use those assessments on a day-to-day basis and actually build value for the hygiene appointment, but also revenue for the entire practice. Yeah, that totally makes sense. So what do we do with a practice where traditionally for years in their office, they've had a hygienist who they are looking to just churn out more? pro fees and root planing and scaling because that's where they see the need and that's where they see the revenue and that's what that hygiene department is for and they take your course and they listen to you speak and what what's the first step to transform themselves into into this kind of inflammation prevention specialist practice focusing on prevention That's a great question. And I believe the first place to start, Phil, is calibration. We have to start with a common ground on how we're going to move forward as a practice, have a general philosophy on how we're going to approach our patients. Most practices employ a philosophy of focusing on the periodontal aspect first, the orthodontic aspect of oral health second, and then finally any pressing restorative needs we finalize. And that may be an implant or a crown or bridge or something along those lines. have a common philosophy. We can calibrate ourselves on how we're going to identify opportunities to employ this when we're seeing our patients. And so just starting with the conversation, if you've seen something that you've, if you see something that you liked or heard something that may work for your practice, but you're not sure how to integrate that, I'd be more than happy to help. And you all can contact me or reach me via email. My email is msmurria at icloud.com. That's missmaria at icloud.com. And I'd be more than happy to support you all. on how to integrate a philosophy of being more proactive rather than reactive, especially coming from the inflammation prevention specialist standpoint. To wrap up this podcast, and it's been a good one, there's certainly some really good insights that you've brought to the table here. What communication strategies can you recommend that can aid in the profitability of a preventative appointment? So that's a great question as well. I would say when we are focusing on educating the patient, one thing that we can do in communication is maximize the handoff. When we're talking with the doctor or the person who's going to provide the periodic examination, you want to talk exactly about what you have. documented during those assessments so when the clinician comes in and they want to know what happened during that exam you just want to highlight what happened during those assessments so did you document recession were there any areas that could be looked at in a more proactive approach and what were the treatment recommendations that were outlined so again if we use that case of a patient who has recession during the handoff it may be something along the lines of you know fills in for his hygiene visit today and he told me that he had insensitivity We applied some pro fluoride L, but we also realized with our digital scan that Phil has lingual inclination that's directly affecting tooth number 29. We talked about some long-term options, which is uprighting the teeth, and Phil is extremely interested in moving forward with that. And what do you think, doc? And that's when the doctor takes over. And now they're talking about, in addition to the pro fluoride L, how they can get the patient to come back for a consultation for clear aligners. So just really talking about the assessments during the handoff is a great communication strategy and having that more. proactive approach in the hygiene department. Do you think dentists in general take advantage of the opportunity that the dental hygienist gives to not only the dentist but the practice as a whole to generate interest in getting the treatment that that patient needs? As a whole, Phil, I'll have to be completely honest. I would say no. I think most dentists capitalize on seeing more patients and they think that just having that revenue of the prophy alone is what's going to drive the practice. But when you have fewer patients or maybe eight, seven to eight patients in a day, if it's an eight hour day, that's going to allow you that time to fully engage the patient and an immersive experience is going to be prevention focused. Yeah, it would be great if we had some. real data, maybe we do, where we compared practices that dental hygienists saw, what, 12 patients a day? Is that too many? Is that unrealistic? I think that's realistic if you're thinking of a practice that's seeing patients on a 30 to 40 minute interval. Right. So 12 patients a day, but then you go to the flip side into more of a inflammation prevention specialist approach, which is more preventative. And then maybe you see seven patients or eight patients. So that's a reduction of four patients a day. But by the end of three or four months of running this kind of practice, you might see way more revenue, less patience, right? It's possible. A larger, a much larger return on your investment when you focus on an education-based and assessment, an assessment-based dental hygiene department. Because it's not enough to just do the assessments. You have to educate the patient on what they mean and how they can be more proactive and using these assessments to encourage them and celebrate that changed behavior. Yeah, it's not enough to just say that the assessments are to find disease. It's also to celebrate when the patient is moving in the right direction as well. If you have a four millimeter pocket that shrinks to a three, celebrate that too. Thank you, Alicia, so much for your input. We certainly want to have you on future Viva Learning podcasts. Thank you so much for being with us. appreciate you so much. I hope you have an amazing day. 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