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Howard Speaks: Why Two Out of Three Cavities Go Untreated by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

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by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

Every year, since 1991, there have been more cavities diagnosed than the year before. That’s a terrible statistic.

What would happen if the fire chief of a city reported that in the 23 years he had been in the position, more houses had burned down each year than the year before?

Legendary, successful mayors are the ones who substantially lower the crime rate while they’re in office. “I’m so proud of the fact that there were more murders than last year! We’re hoping and expecting even more next year!” said no one ever.

On average, for every three cavities a dentist diagnoses, he only removes the decay on one. One! He doesn’t remove the decay two out of three times! That’s below average dentistry! We all claim to be good dentists, but on average, we can’t all be.

I always hear clinicians say they’re 20/20/20 dentists—“My fillings are bonded with greater than 20 megapascals.” “All my indirects fit within 20 microns.” “All the materials I use wear less than 20 microns a year.” They use their fancy adhesive bonding agents and their fancy CAD/CAM machines on one-third and do squat on the other two-thirds.

You are a dentist because you got A’s in science and math, and because you (hopefully) genuinely care about removing decay and disease. But part of the problem is that dentists typically aren’t good at sales. And to fix patients’ cavities, and in turn, prevent the spread of disease and decay, you’ve got to convince them they have a problem that needs fixing.

Say you have a patient in the dental chair and you are presenting treatment after an exam. You might say something really technical and clinical. “You have an interproximal legion on the distal of three. It’s causing irreversible pulpitis. You’ll need endodontic therapy, a post-build up and a full-cast restoration.” The patient just stares at you like a deer in headlights. She doesn’t understand what you just told her, doesn’t realize the importance of fixing the issue and because she, like most people, doesn’t buy based on information, she walks out to the front desk, says she’ll call later to schedule her treatment and then leaves. Two out of three cavities are walking right out your front door!

Let’s look at this same situation by putting ourselves in different shoes. Say a dentist was selling real estate. He’d walk in the house with the client and say something like: “The altitude of this house is 368 meters above sea level. This side of the street gets direct sunlight in the morning. The climate of the area is mostly rainy…” Boring! It would be all technical information.

A good real estate agent, on the other hand, would present a house much differently. She would walk you into the living room and help you imagine the big parties with family and friends that you could have. She’d sit with you around the fire pit and talk about how fun it would be to BBQ on the patio during the summer. She’d make it relatable. She’d make it an emotional decision rather than an informational one.

There is a biological science to selling. There are only two things humans can love. It’s not ice cream or cookies or dogs or cats or family. It’s dopamine and serotonin.

Your dog sees you walk in the front door from work. His tail wags and he jumps up, excited to see you. You think you love each other but you actually love the two chemicals. The real estate agent is secreting dopamine and serotonin too.

What on your résumé makes you think you’ll be good at sales? Sometimes dentists are their own worst enemies. Patients are already on edge when they visit the dentist, so it doesn’t take much to (even unintentionally) put them in fight or flight mode. Looking back to the patient in the dental office, it’s no wonder she wasn’t compelled to schedule her treatment. You weren’t giving off any dopamine or serotonin. In fact, you were secreting norepinephrine and adrenaline, which have the opposite effect.

We’re putting patients in fight or flight mode because of the clinical information we’re spouting off and because many dentists feel compelled to comment on previous dental work. If you’re not impressed, keep it to yourself. In 1997, William Ecenbarger published an article in Reader’s Digest called “How Dentists Rip Us Off.” The investigative journalist went to 50 different dentists for consultations. He received 50 different treatment plans. Dentistry is as much an art as it is a science. It’s inexact. So unless you see shoddy dentistry worthy of malpractice accusations, don’t badmouth! What if the patient was a family friend with her previous dentist? What if their kids played sports together? If you’re badmouthing her previous dentistry, you’re telling the patient that her decision to have treatment years ago was a bad one, but now you’re asking her to make the decision for treatment again with you.

The point is we need help selling treatment. Most of us are just not biologically good at it. I’ve had the same dental assistant for 25 years. She is great at presenting treatment because she gives off serotonin and dopamine. She’ll present treatment like this: “You have two cavities, but I wouldn’t fix them just yet because if the doctor puts those fillings in there, he’s going to match them to the existing teeth. So, what I would do is bleach them first. But before you do that you need to have them cleaned. So let’s get you in the hygiene department and we’ll get all the plaque and tartar off your teeth, then we’ll bleach them in the office and send you home with bleaching trays. Then we’ll remove those cavities and match the fillings to the pretty white teeth. It’s going to look great.” The patient gets excited about what her new smile will look like!

I lucked out having an assistant who is so good at selling dentistry. But the fact is, I still have a treatment coordinator. This is something that orthodontists figure out two years into practicing and nine out of ten dentists never figure out. Treatment coordinators have been known to triple treatment production! By hiring a TC we can lower the rates of decay and disease, and maybe clean out two of three or three of three cavities that come into our offices!

Howard Live
Howard Farran, DDS, MBA, is an international speaker who has written dozens of published articles. To schedule Howard to speak to your next national, state or local dental meeting, e-mail jenna@farranmedia.com
2014
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SEP		 American Association of Dental
Office Managers (AADOM)
San Diego, California
Teresa Duncan – 732-842-9977 www.dentalmanagersconference.com
9
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East Peoria, Illinois
www.pdds.org
23
OCT		 Annual Fall Seminar
Detroit, Michigan
Dr. Joseph R. Nemeth, DDS & Associates
Don Tremblay - 248-357-3100
www.drnemeth.com


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