Appointment Etiquette

Is it acceptable to ask a patient if you can move their appointment?

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The world of dentistry revolves around appointments which is great until something occurs that throws off the schedule. It happens inevitably, and when it does, is it acceptable to move a patient’s appointment? That depends on some very important guidelines which include proper training, communication, and follow through to ensure that the schedule flows properly and at maximum efficiency without offending and inconveniencing patients.

First of all, have a scheduling policy and make sure the entire team understands and follows it methodically. Most of the time, the front office will be in charge of appointments, but it’s a good idea to have the entire team on board. The schedulers should have a good understanding of how appointments work and how to schedule to maximize production while running on time. If the scheduling is done properly in the first place, moving appointments will be kept to a minimum.

Second, when scheduling patients initially, know what to say and how to say it so that if changing the appointment is necessary at a later date, it will be simpler. Ask the patient if it’s permissible to contact them regarding their appointment and the best way for them to be reached (phone, text, email). Explain that you may contact them as the appointment gets closer if it’s found that there’s a more convenient time for their schedule.

Third, keep detailed notes concerning any conversations with the patient about an appointment change. It’s also prudent to indicate if the patient mentions any days or times that are off limits. Keeping detailed records assures that unnecessary calls aren’t made which may irritate the patient. Correspondence should include information such as who called, when the call was made, and what appointment was offered. If it’s necessary to leave a message,  it’s imperative that the details are documented and that everyone is on the same page. For example, if you leave a message, make sure that the patient understands that they must contact the office regardless or the original appointment time will remain unchanged.

Fourth, verify that the detailed notes are read by whoever is phoning the patient. Save yourself embarrassment by knowing what the patient likes relevant to appointment days and times. Don’t tell them that you are calling because someone canceled last-minute because it’s negative. Tell them that you remember them saying that they prefer morning appointments and that you happen to have a morning opening. Saying something like this shows the patient that you are thinking of them and looking out for them as well.

Finally, don’t move the patient’s appointment more than once. Never continue to call patients to move their appointment. Also, if a patient does allow you to move their appointment, make a note of it and thank them when they arrive at the office.

Responsibilities of the Dental Patient

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“There is nothing that the dentist can do which will overcome what the patient won't do” is a saying in dentistry that’s so very true. While your dentist can treat you with excellent clinical skills, what you do or don’t do at home every day will determine the outcome of your dental health. What are your responsibilities as a patient regarding the success of your treatment?

  1. First and foremost, make an appointment with your dentist and be seen on a regular basis. Many people are under the impression that they only need to be seen if they’re in pain when nothing could be further from the truth. Once discomfort is experienced, it can be too late to save the tooth. The best plan is to see your dentist for a cleaning and examination every six months or more frequently if it’s recommended. If your insurance only pays for a twice-yearly cleaning and exam and you’ve been advised by your dental team to be seen more frequently, please consider their suggestion.
  2. When you make an appointment, it’s important to keep it even if it becomes inconvenient. Time tends to get away from us, so if you have to miss an appointment, make another one as soon as possible.
  3. If restorative treatment becomes necessary, inquire about your options especially if the recommended treatment is out of your price range-even with insurance coverage. Sometimes, treatment can be done in stages as not to break the bank. If there’s only one choice of care and it’s outside of your budget, explore third-party financing options. There are several available, and many have decent interest rates and terms of service.
  4. Follow instructions set by your care team. Your dental professionals should provide short-term and long-term instructions concerning maintenance of your oral health. More than likely, suggestions will include American Dental Association approved devices such as power(electric) toothbrushes, floss, water flossers, interdental aids, mouthwash, and toothpaste.
  5. Once treatment is completed, it’s still important to visit your dental team twice per year or more if recommended to establish that your oral health is stable and doesn’t require further attention.

Dental professionals want nothing more than to keep their patients healthy and happy. Your relationship with them is paramount and if you’re not comfortable, seek an office where you feel you’re part of the family.

Financing for Dental Patients

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Once upon a time, the dentist was the financier for those patients who carried a balance for services rendered. Even with dental insurance, many patients have a balance after they’ve reached their benefit maximum.

Today, even if the patient's benefits are maxed out, it doesn’t mean they must wait for needed treatment or that the dentist has to carry the burden of financing. Furthermore, cosmetic procedures aren’t usually covered by insurance anyway, so the patient may have to be financially responsible for the entire procedure.

Most insurance companies allow a maximum amount of benefits per year and that maximum is around $1500-2000 which isn’t a lot in regards to dental treatment. Also, the insurance will only pay the usual and customary fees meaning that the carrier decides what fee the dentists (providers) should be charging for each service and they will only pay that amount.

By using a third-party for financing, the dentist (provider) gets paid immediately and doesn’t have to spend additional time and money trying to collect payments from patients. There are many third-party financiers, and some have attractive payment options such as interest-free periods and programs for those with less than perfect credit.

Becoming familiar with third-party financing is profitable for both the patient and the practice. Patients can progress with treatment without having to wait and risk worsening of the problem, and the practice can enjoy the increase in production without having to become the bank. Make an appointment with your business banker or ask your dental supply representative about third-party financing for your patients. You’ll be surprised at how easy the process is for everyone involved.

Face Masks 101- How much do you know about your surgical mask?

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You probably haven’t given much thought to the mask you don before dental procedures. However, it’s quite important to have the facts when choosing products designed to keep you safe when exposed to pathogenic viruses and bacteria. Let’s explore the what, when, where, why, and how to choose and properly use a surgical dental mask.

What is a surgical mask?

A dental surgical mask is a barrier that protects the clinician from potential respiratory disease agents and is an FDA regulated medical device. Masks are composed of several layers of synthetic microfiber materials created to trap microscopic matter and are manufactured in a variety of sizes and shapes.

When is a surgical mask worn?

The Centers for Disease Control (CDC) recommends that a surgical mask be worn during procedures which produce aerosols, spattering, or splashing of blood or other bodily fluids. The mask must be disposed of after each patient, following one hour of continuous treatment, or every twenty minutes during a procedure producing a high level of aerosols.

The American Society for Testing and Materials (ASTM) specifies the performance of face masks and certifies the levels of mask type to be worn based on the procedure.

ASTM low barrier level 1 is used during procedures where there is a low concentration of aerosols, spatter, or fluids being produced. Examples are: patient exams, lab work, taking x-rays, applying fluoride, and disinfecting the operatory.

ATSM moderate barrier level 2 should be donned when there is a moderate concentration of aerosols, spatter, or fluids being produced. Examples include: Use of the ultrasonic scaler, hand scaling, rubber cup polishing, air polishing, use of a slow speed handpiece, placing a filling or sealant, placing a permanent or temporary crown, placing an inlay or onlay, taking impressions, and any other procedure which would produce moderate aerosols, spatter, or fluids.

ATSM high barrier level 3 masks should be worn where there is a high probability of concentration of aerosols, spatter, or fluids being produced. Examples include: ultrasonic scaling, air polishing, use of a high-speed handpiece, extractions, implant placement, any surgical procedure, and any other procedure which would produce a high-level concentration of aerosols, spatter, or fluids.

Where is a surgical mask worn?

A mask is worn on the face of the clinician and must cover the nose and mouth without actually touching the nostrils or the mouth. It’s attached to the head securely so that the clinician is comfortable and able to work effectively and safely. 

Why wear a surgical mask?

Dental aerosols are produced in the highest concentration within two feet of the patient being treated. Furthermore, the clinician is usually within this two feet and is exposed to the larger droplets and the remaining smaller nuclei droplets. These smaller droplets remain airborne for extended periods and can contain pathogenic viruses and bacteria.

How is a surgical mask used properly?

  1. Wash hands before touching a clean mask.
  2. Handle the mask for proper placement- the side of the mask which is facing up in the box is always the front of the mask. The pleats of the mask should be facing down when opened. The metal noseband is bent to the contour of the nose.
  3. Hold the mask by the ear loops and place the loops around each ear.
  4. Form the malleable metal strip to the shape of the nose.
  5. Extend the bottom of the mask over the mouth and chin.

Some other factors to consider when choosing a mask include confirming that it has a high bacterial filtration efficiency (BFE), it doesn’t cause fogging of eyewear, and it’s made of a material that doesn’t irritate the skin or cause an allergic reaction. While it may take some time to find a mask which suits you and your team, most manufacturers offer samples so everyone can try different types and make an informed decision.

Sit/Stand Positioning- In The Operatory?

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If you’ve been in dentistry for at least 25 years, you remember and may still sit on operator stools manufactured for everyone regardless of their size, height, leg length, shape, torso, or weight. Many clinicians sit on stools provided by the office and have never even heard or thought of ergonomic seating. Conventional seating taught operators to sit with their thighs parallel to the floor which flattens the healthy curve of the spine.  

Sit/stand positioning has become quite popular in many traditional offices. However, the dental office isn’t traditional, and sit/stand techniques must be altered to make it feasible to treat patients while keeping the spine in a neutral position. Studies have shown that adopting the sit/stand technique decreases time sitting, increases muscle activity, expends more energy, and reduces sedentary episodes. Individuals adopting this system report less fatigue, decreased low-back pain, less neck and shoulder pain, and increased productivity. Two options are available for clinicians to create a modified sit/stand technique: the stability ball and the saddle stool.

Stability balls have been utilized in exercise classes and physical therapy for many years and weren’t intended to be used as a seat. They started making their way into offices when it was determined that balls make the user sit up straighter thus maintaining the lumbar curve. If choosing a ball seat, it’s crucial to select a ball that’s appropriate for your weight, height, and leg length. Stability balls are better suited for a workplace other than dentistry where the user sits at a desk and has limited movement. The problem with using stability balls in the operatory is that they are large and treatment rooms are small. The other issue is that the ball must be inflated or deflated depending on the patient.

The second and probably better option for clinicians is the saddle stool. This type of seating promotes proper posture and is easy to maneuver around the operatory and the patient. The shape of the saddle places the pelvis in a neutral position. Western and modified English saddle stools are the two available varieties. Most practitioners prefer the modified English stool because the seat is wide with a slight rise in the middle allowing the operator to sustain a wide stance. The Western saddle has a prominent hump and is narrower which is better suited for those with a narrow pelvis and prefer a more narrow leg stance.

As with any new device, some discomfort may be experienced initially because sit/stand positioning engages different bones and muscles than traditional seating. However, prevention is key to maintaining a healthy and happy body. Furthermore, many companies will send a representative to your office making it easier to try different models before you purchase.


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