Letters To The Publisher

What Acid Dissolves Stains?
I was at the program in Las Vegas recently and met you after the course waiting for a taxi at the hotel. I have a patient that is a 14-year-old male with deep brown intrinsic stain on both his maxillary centrals. I remember you addressing a similar situation in your practice but I don't remember the acid you used or the specifics of the procedure. If you could either refresh my memory or point me in the right direction to find out what to do I would be very grateful. Also have to tell you that you have been instrumental in my renewed interest in what I do, what I learn, and how I go about my day to day life in dentistry.
Chip

Greetings Chip,
I use muriatic acid and pumice on a prophy cup. Muriatic acid is the old name for hydrochloric acid. I have my local pharmacist make me a bottle of HCL 14%.

HCL is a strong, corrosive, inorganic acid (HCl), manufactured by absorbing hydrogen chloride in water. It is one of the most corrosive of acids. This is what is also known as pool cleaner. I was always amazed at what it would remove from our swimming pool walls. In fact you could buy HCl at any pool cleaning supplies store. I just thought it looked better to get it from a pharmacist.

In regards to, "or point me in the right direction to find out what to do I would be very grateful." This is why I built www.DentalTown.com where no dentists will ever have to practice solo again. Several 1000 dentists log onto the message boards each day posting questions and answers to questions such as these. Please log on and give it a try. You have to register the first time. Don't worry it's free!! Go to the message boards and post this question somewhere under cosmetic dentistry! You will be surprised at how fast some sovereign dental colleague will answer you and how much fun it is!
Howard

Problems With Insurance Co-pays
I've got a question for you. We are having a problem with patients not under-standing that we are estimating their insurance co-pays. They don't understand that they may owe additional monies after insurance has paid and they think that they don't need to pay that part of the bill. Do you have any suggestions? We have given them a written handout explaining the whole "insurance is an agreement between you and the insurance company..." deal but they don't seem to comprehend. I'd appreciate any feedback you may have.
Lynn Herpy

Hi Lynn,
This is a very tough situation. I think that this is an on going problem in dental offices everywhere!

We too had a page length form that we had all new patients read over and sign stating that they understood that their insurance may not pay what we are estimating. We decided to do away with that form because all it did was confuse those who don't understand insurance... the patients.

We do everything we can from the very beginning of the patients experience with us to help them understand that their insurance may not pay.

When a patient calls to schedule their new patient exam one of the first questions we'll ask is "Do you have dental benefits?" If so we explain that if they can choose their own doctor we will file their claim BUT we are not providers for their insurance co., so what we will be working with are estimates of their benefits. We have a plaque in our lobby stating, "As a courtesy to our patients we will file your insurance. However, we cannot guarantee your insurance will pay as estimated. The final account balance remains your responsibility."

As we go over every treatment plan with the patient, we once again stress to them that their portion is based on an estimate only. If insurance pays less than we are estimating we will send out a statement for the remaining balance that will be due at that time. For explaining the difference between amalgam and composite fills we not only verbally tell the patient that insurance may only pay the amount of the amalgam and the balance would then be their responsibility. We also have a red ink stamp that we stamp on each treatment plan containing a posterior composite stating the same thing.

You can tell them over and over that their portion is an estimate and that there might be a remaining balance. I still receive many phone calls after monthly statements go out with patients asking why they have to pay more when they paid what they were asked of at the time of service. I hope this helps!
Leah Colatorti
Front Office Supervisor, Today's Dental

Your Tapes Helped Beat Burn Out
Just wanted to say "Thanks"! I have learned a TON from the DentalTown boards. I am on Day 15 of the MBA tapes. (Feel like I know you by now.) They are just great! My husband enjoys them a lot also, and he is not even a dentist.

I was feeling sort of burned out a few weeks ago. I can't tell you how much your tapes have helped me. Now I really look forward to my morning commute so I can listen to them. You have inspired me to make some positive changes in my attitude and practice. And I feel better about the way I am already doing a lot of things, like the way I "am" with my patients and staff.
Kim Sineri, DDS

Greetings Kim,
Wow! What a nice email this Friday morning! You just made my day! Howard

Oral CDx Message Hits the Mark
Thanks for the oral cancer report in the Nov. issue of DentalTown from the ADA meeting. I've been meaning to incorporate the Oral CDX screening test into my practice but wanted to in just the right way. Now I have it. I will use your article with appropriate credit and use it to make the recommendation. Your bottom line no nonsense message hits the bulls eye.
Winston Eaddy