Second Opinion: Don’t Let Raising Your Patient’s Dental IQ Interfere with Case Acceptance By Dr. Paul Homoly, CSP

If I’ve heard it once, I’ve heard it a thousand times; “The key to case acceptance is raising the patient’s dental IQ.” Throughout my entire career in dentistry, I learned that patient education is the “holy grail” of case acceptance. I recently walked through the exhibitor booths at a major dental meeting and saw all the DVD- and multi-media-based patient education tools, and heard vendors promise how their system will raise the dental IQ and educate patients into case acceptance.

Let me ask you this – is it true? Is raising the dental IQ the magic pill of case acceptance? Is it unthinkable within the culture of dentistry to suggest that in the challenge of case acceptance, patient education is not king of the hill? My experience of the last 30 years is this – for routine care dentistry totaling $3,500 or less, patient education is key. For complex-care dentistry with fees in excess of $3,500, raising the dental IQ is not the critical contributing factor of case acceptance. Let’s look at why:

Who’s Going Kayaking?

Imagine you’re a 46-year-old father, and your 14-year-old son comes to you with an outdoors magazine, shouting, “Dad – this is so cool!” He’s pointing to an ad for a whitewater kayaking trip: six days on the river, camping, a guide, the works. “How much is it?” you ask cautiously. “$6,500,” he replies. $6,500! You’ve got estimated taxes due, your wife’s car needs a new transmission… but you look at your boy’s face shining with excitement and you say, “OK, let’s do it,” and your son is thrilled.

The next day you bite down hard and break off the cusp on tooth #30 and a sharp edge is cutting your tongue. Now, you’re a normal person, you haven’t been to the dentist in about five years, so you ask your wife, “Honey, where should I go to the dentist?” She says, “Go to Dr. O’Malley. That’s where I take the kids.” So you go see Dr. O’Malley. Well, Dr. O’Malley’s just been to the “Institute of the Milky Way” and he’s all fired up. You walk in his office and the first thing they do is read you their mission statement and give you a tour of the office. Then they start the complete examination. They take a mouthful of radiographs, study models and photos and begin to pound in the patient education process. They spend 45 minutes with you after the examination – explaining to you all the stuff that’s wrong with your teeth, how they got that way, and show you three ways to fix a dozen different things. You don’t really understand much of what they’ve said, but they give you a nice flower.

You go back a week later for the case presentation, and it’s magnificent. There’s a big color monitor up in the consultation area with the before-and-after photographs and models, and the dentist goes into a tooth-by-tooth description and does a smile analysis, and he’s very excited. Finally you ask, “Doc, how much does this cost?” and he says “$6,500.” Now let me ask you, what’s going to win – the dentist or the kayak trip? One hint… it’s not the dentistry!

Here’s the question you need to ask when practicing complex care dentistry: “How many of my patients are going kayaking?” What’s the answer? They all are. From their point of view, patients have much better things to do than give their time and money to you. Instead of focusing on raising their dental IQ to what they need, why they need it, and how you’re going to do it, learn how to discover what’s going on in their lives and how complex-care dentistry fits into their lives either now or later. Educating them that they need to fit their lives into our complex-care dentistry doesn’t work. How do I know? You’ve proven it, haven’t you?