Roadmap of preventive dentistry
November 19, 2020
Dr. Daniel J. Poticny, DDS

The True Value of Preventive Dentistry

Preventive dentistry isn’t a new concept, but it could present a new pathway to increased patient acceptance, practice growth and profit. It’s time to take a closer look at the potential of prevention.

Dentistry is always changing, and we’ve seen unprecedented changes in our field. But some familiar challenges remain – shifting demographics, new patient demands, emerging insurance incentives – while others await us around the bend. As we navigate these challenges, it’s important to be proactive. It may be tempting to “watch and wait,” to see how things change, but dental professionals and practices need to be ready to adapt to this evolving landscape – both to remain profitable and to provide the best care possible. And all of this means focusing on prevention.

The Landscape of Dentistry

General healthcare fields have already begun to shift from reactive to proactive treatments, including encouraging routine check-ups and screenings, promoting wellness programs, and other more holistic strategies to help patients lower their risk for chronic diseases. While dentistry tends to follow general healthcare trends, in this regard, the field has been much slower to adapt.

The philosophy – and benefits – of prevention

Preventive dentistry isn’t a new concept. In fact, dental professionals have been promoting the value of oral hygiene and early intervention in the prevention of disease and maintenance of oral health for centuries. And in the modern era, scientific and clinical studies have supported the benefits of minimally invasive, preventive treatments.

Minimally invasive dentistry is a growing trend that focuses on conserving healthy oral tissues by preventing disease from progressing or happening in the first place. The reality is that cavitation (the precursor to caries) is a nearly 100% preventable and even reversible disease. Drilling is often the first course of action – but it doesn’t need to be. Every time you drill to restore a tooth, you’re guaranteed to need to drill again down the line. Preventive solutions, like sealants, fluoride treatments and improved hygiene, have demonstrated incredible success in reducing decay as well as the need to drill.

Professional perspectives

Despite all of this, many dental professionals still see prevention as an ancillary service and are more likely to resort to traditional “drill and fill,” or “watch and wait” approaches to treating decay. In fact, according to a National Institutes of Health survey, 63% of dentists would operate on a tooth with decay that hasn’t penetrated through the enamel, regardless of the patient’s hygiene habits.1 In addition, I would estimate that only 20% of practices nationwide are primarily focused on prevention. This isn’t to say that dentists don’t recognize the benefits of prevention for patients – we do still recommend brushing and flossing, after all. The main roadblock to a preventive care mindset, unfortunately, is profit. Prevention is consistently seen as a low revenue service with a high operational cost, and not worth primary pursuit.

So, what’s going to tip the scales?

Changing demographics, changing needs

Patient needs and expectations have changed drastically over the years, including a growing desire for more natural-looking, healthy smiles for life. Older generations are retaining their natural teeth and overall health for far longer than in previous years and want to maintain their smiles (as well as their wealth). This makes them more inclined towards a prevention mindset than previous generations.

Add much more aware, much more proactive and holistically minded younger generations to the equation. These patients are more wary of “sales-pitches” and unnecessary treatments. They want each appointment to have value – and dentists will eventually have no choice but to match their patients’ mindset in order to remain profitable.

The dental-systemic connection

To this day, dentistry and medicine are commonly and erroneously viewed as separate professions with little to no overlap. However, despite the fact that our educational systems, insurance structures, patients and some professionals may treat the mouth as an isolated field, oral health is actually a window to a patient’s overall health. In fact, more than 90% of all systemic diseases have oral symptoms – and dentists have the opportunity to play larger roles in patients’ overall health (CITE, Academy of General Dentistry). After all, dentists are physicians – and overall wellness is part of providing a high standard of care.

In addition, patients are beginning to better understand and appreciate the ramifications of comorbidities and the way seemingly disparate parts of the body connect. It’s likely that, in the coming years, patients will not only be more receptive to preventive treatment but may also be more open to discussing their overall health history with their dentist – and practitioners should be prepared.

Cloverleaf dental-systemic connection

Profitability/Practice Growth

Preventive dentistry presents more opportunities for practice growth than many realize – and the benefits go well beyond simply improving the bottom line.

Patient acceptance

Increasing patient acceptance is often tied directly to increasing revenue, but the relationship isn’t that simple. Patients who only come in when they have specific, need-based problems, such as a cavity or chipped tooth, are bound to accept treatment – but how likely are they to come back? The truth is, dentistry is the only medical field in which patients consistently question the value of treatment and “put off” visits for years.

Leading with prevention, however, has the potential to increase patient acceptance rates, patient satisfaction, and loyalty. By demonstrating that you and your team are invested in a patient’s overall health rather than just numbers, patients are more likely to see the value of what you suggest – and accept treatment even if it’s out of pocket or outside their network. In addition, building these relationships (which we’ll discuss in more detail later) can lead to lifelong patients as well as referrals.

A head for hygiene

Hygiene appointments may be routine, but hygienists’ skillsets should not be taken for granted. In addition to their clinical skills, hygienists should have robust interpersonal communication skills. They often spend more one-on-one time with patients and are tasked with discussing and reassuring patients about their treatment options. They may be the first to hear patients’ questions and concerns. And they already know how to have the prevention conversation with patients, because hygienists already know its value as a health service.

When dentists partner more closely with their hygienists, the whole practice can benefit. However, all of these benefits can’t be utilized unless the entire team is invested in prevention.

The insurance question

Regardless of the interconnectivity of the mouth and the rest of the body, dental insurance isn’t like traditional health insurance. It’s not about catastrophic coverage; it’s a dollar benefit with an extremely low annual cap applied toward regular dental care, or routine maintenance. Not all treatments will be covered, of course, but we are now seeing emerging incentives for preventive care – much like current metrics-based incentives for the lifespan of a crown and dental prosthetics, for example.

But the real issue with insurance isn’t about the coverage itself. It’s the patient mindset that, if a treatment isn’t covered, it’s not worth pursuing. So how do you get patients to understand the true value of prevention?

Profit and practice growth

How to Talk to Patients

What makes a patient turn down recommended treatment or go to another practice? One factor could be how practitioners present recommended treatments. Patients don’t respond well to feeling guilted, talked down to, or sold something they don’t need. And while you know you’re recommending beneficial care, that information must be conveyed in an accessible, respectful way – or risk rejection.

Communication and relationship building are skills – and they’re every bit as important to the success of a practice as anything technical. Developing your communication skills can help your practice regardless of your treatment philosophy. Likewise, focusing on prevention could actually open a door to better patient relationships, increased acceptance and practice growth.

Building patient relationships, building your practice

Dental care is often viewed as too expensive. Patients tend to equate dentists to a drill and a bill, and some may dread their annual visits. Changing this reputation starts with how you interact with your patients.

Patients are more than their acceptance rate, their treatment plan or their smile: they’re people – and building strong relationships means treating them as such. This means spending more time with each patient (no more 2-minute routine hygiene exams) and using that time to have open, honest conversations about the care they need. Talk about preventive treatments as a way for patients to set themselves up for better long-term health (and keep away from the drill).

For example, adult patients often think of sealants as treatment “just for kids.” So, ask them: do your kids have cavities? If sealants work for kids, why wouldn’t they work for someone older? Decay doesn’t have an age cut-off, and neither does prevention. When patients see that you are putting yourself in their shoes, they’ll understand that you’re on their side.

When a patient completely trusts your philosophy and that you’re committed to their health, they stop questioning your recommendations – and are that much more likely to accept long-haul preventive treatments and recommend you to others. Working this way can also help establish you, your brand, and your practice as a valuable, personable service that appeals to the patients you want to treat. In turn, they will grow your practice by referring like-minded friends, family, and colleagues.

The money issue

Many adult patients will refuse treatment, preventive or otherwise, due to two critical factors: cost and insurance coverage. The fact of the matter is that preventive treatment beyond basic prophylaxis isn’t covered for adults, and acceptance comes down to showing them that prevention is worth the initial cost.

And while discussing money can be awkward, if you reframe the conversation to other investments patients make in their daily lives, you can help them see the value of prevention. For example, sealing windows is an investment in time and money – but one that can save much more down the road by preventing mold or rot due to water damage. Similarly, by paying out-of-pocket preventive treatments now, patients can help avoid problems that would require expensive, aggressive treatments down the line. And once they’ve invested in treatment, make sure to emphasize the progress they’re making with every visit. That way, you can show them that the expense was worth it, and that you’re paying attention.

Damaged road

Conclusion

As the field of dentistry grows and evolves, we have the opportunity to improve our patients’ health, repair longstanding negative mindsets, and reshape how our industry operates. By focusing on prevention, you can give your patients a head-start on the road to lifelong oral health – and demonstrate your practice’s dedication to a higher standard of care.

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