Interrelation of Problems in Dental Practice PATIENTS Accept only emergency work Think of dentistry as a commodity, i.e.

, in terms of fees for different materials Will not accept reasonable fees Will not accept complete examination, including radiographs Want to bargain Will not accept payment plans Do not meet payments promptly Do not appreciate high standards of work done Break or cancel appointments Are late to appointments Drop out before work is completed Do not respond promptly to recall notices Do not refer others

FINANCIAL INSECURITY Lack of practice growth Low percentage of complete mouth rehabilitations Low percentage of response to recalls Low percentage of recommendations Insufficient income for effort made Poor collections High credit losses Low financial reserve Lack of funds to meet obligations Unfair competition Abnormal fluctuations in income Fear of future insecurity

PRACTICE MANAGEMENT PROBLEMS Too long hours Pressure due to more patients than dentist can handle Patients kept waiting No time to perform good dentistry Overlapping of appointments Time lost between appointments No time for vacation Lack of system in office procedure Unproductive time Inadequate records Slack periods High overhead Too low fee schedule Irregular fee schedule Poor arrangements for payments Inadequate down payments

many mouths have fallen into a state which involves not only a good deal of time and difficulty to correct but also considerable expense.The Story of Modern Dentistry 1. possibly due to unhealthy conditions of the mouth and teeth. Indicate that dental practice has progressed. relieve the pain. 2. 3. For example. Wouldn’t it be harder for a person like this (show illustrations on page 6. Do you know that. a wife (or husband)? Think of the effect of his appearance on others! He is afraid to laugh heartily or even smile because he is so conscious of his faulty teeth. Express idea of prevention. As a result. Most people do not realize that many diseases of the Body can be traced directly to the mouth and teeth. “But this is not all. or perhaps fill the tooth. 4. Suggest connection between oral and general health. “ When a patient came into a dental office. “Fifteen or twenty years ago the average person paid little attention to his mouth until he had a toothache Or other annoyance. I don’t know if you have any of these symptoms. pains and aches in the joints. and of course your mouth doesn’t look look anything like this. . etc.7 and 8 of “teeth. “There are other troubles which can be avoided. “Today we dentists are interested in trying to Prevent all these troubles. loss of weight. Relate to individual case and suggest that much can still be done to correct damage. 6. Suggest that neglect Causes trouble and expense. headaches. 5. may be symptoms of more serious ailments.. Demonstrate importance of esthetics. the dentist would extract the tooth. Health and Appearance) to get a job. They do not realize that early and regular dental care will save a great deal of trouble. stomach trouble. But every one of these cases started with some small damage which would never Have reached this stage if cared for in time. He gave little to avoiding toothache or the loss of teeth. “Now. except for accidents or unusual illnesses a person need never lose a permanent tooth? Or never even have a toothache? That a child need not and should not lose any primary teeth prematurely? “Most people do not know these facts.

As You know. This can best be done by explaining that.” . In fact. While we cannot undo it. at least the most serious conditions will be taken care of and we will be in a position to plan for your whole mouth in steps which will not be a financial hardship to you. two enemies must be fought: caries and periodontoclasia.” “If the examination should reveal that there are more unfavorable conditions than you expected and you feel you cannot afford to have all the work done now. there are always new developments in dentistry that aid us even further in doing this. we dentists have always stressed the importance of checking the mouth regularly because in that way we can help prevent toothaches and loss of teeth. Of course. “The first step is a thorough examination of your mouth to make sure that no condition is overlooked which might lead to toothaches and loss of teeth later on. so that our patients can receive the fullest benefits modern dentistry has to offer. his next step will be to present to the patient the need for a complete examination.” When the dentist has reached this point in the education of the patient. fifteen or twenty years ago…. in order to protect the mouth from further damage. we can do a complete job in correcting it and thus help to prevent further damage. from what you tell me. and dentists today try to keep up with them so that our patients will get all their benefits. Progressive improvements are being made in dentistry.” “I am glad you came back before having any serious discomfort.“In your case. it seems that some damage has already been done.” (continue with the “Story of Modern Dentistry”) “I am glad you noticed that. We try to keep up with these advances as they are made.

overhanging margins 5. Normal teeth 2. Impactions 8.I. retained roots. Mixed dentition with malocclusion present due to prematurely lost deciduous tooth or teeth. traumatic conditions d) edentulous area showing normal and abnormal ridges. and. thin knife-edge alveolar process 9. a similar case corrected to normal relationship 5. showing: a) thin knife-like ridges b) concave ridges c) fairly well rounded ridges . Study models to illustrate 1. also indicating types of ridges resulting from resorption 6. loss of contacts. cysts. Tarter 10. Infections a) infected teeth (non-vital and devitalized) b) residual infections. Many teeth missing. drifting. preferably posterior. Conditions of bone and peridental membrane a) resorption of bone b) peridental pockets c) thickening of peridental membrane. One missing tooth. 6. etc. showing in both child and adult a) regular alignment b) crowded. Condition of roots a) curved b) fused c) diverging d) exostosed 7. Enamel breaks 3. Old restorations showing recurrent decay. Edentulous mouth. Series of radiographs to illustrate 1. irregular alignment c) closed bite 2. Children’s mouths a) primary and unerupted teeth b) mixed dentition. plunger points 4. extrusion. with space partially closed. Several teeth missing with extensive disarrangement of remaining teeth and closure of bite. for example. Caries a) caries of lesser degree b) advanced caries encroaching upon pulp c) caries advanced into pulp d) caries advanced into pulp with apical area 4. 3. if possible. normal and abnormal II. All teeth in position. with shifting. several.

III.. Bureau of Public Relations. 2.D. Chicago Ill..A.. Dental Digest Publishing Co.. . Bureau of Public Relations. Visual Education of Dentistry. Books 1. A. 1940. Maury Massler and Isaac Schour. Chicago Ill.D. A. PA.In illustrating a condition by means of study models. the dentist should have at hand radiographs of the same case if possible and use them to reinforce the demonstration. 3.A. Health and Appearance. Pittsburgh. Teeth. Atlas of the Mouth.

Patients statement. She said she had a a cavity in this tooth (point out tooth on models). Assure him that you understand and sympathize with his financial situation. “As a result of that. let me look at it. She could not afford much. In that way. Yet these people want to save their teeth. We therefore discussed her budget with her and arranged suitable payments overa period of time. Show example of a case similar to that of patient. but by finding out all the conditions in her mouth thorough exam. 3. We could have filled the tooth.through these and other means (point to radiographs and study ination. 2. But they wonder how it can be done without spending too much money at one time. Is this the tooth? I’m sure I that his complaint can take care of it today. 4. “I think I have a cavity and I would like you to take care of just this one tooth. Mrs. Many people are in similar circumstances. . This tooth moved out of position so that this point. Care of her mouth without spending too much money at this time. either. “For example. new decay might have set in. Suggest suitable “Now the fee for even the urgent work was more than this patient Payment plans. “ You know. or cusp. 6. “This would have undermined the restoration and the patient would have had to undergo the same trouble and expense again. but I cannot afford very much. They want to prevent unnecessary loss of teeth. Indicate cause and effect of damage. “That’s what you want to do isn’t it.” 1. was packing food between these two teeth and probably helped cause this cavity that she had felt.Suggest “ Of course. Because they had not been replaced the remaining teeth moved out of their normal position ( point out on models). I probably have a lot of other work.__________? 7. In this way she was able to take necessary. Not only did we find the cavity (point out on radiographs) but we also found the conditions which in all likelihood helped to bring it about. these (study models) belong to a patient who was in recently. division models) she knew which conditions were so urgent that they of treatment. “We found that some of her teeth were missing. at this time she couldn’t afford to have the missing advantages of teeth replaced. several things happened. Reassure patient “Very well. I’m glad you told me that you can’t afford very much. particularly in these uncertain times. will be treated as quickly as possible. Test patient’s understanding. could afford at one time. but if we had not found this point and rounded it off. due to continued food packing. if required immediate attention. 5. just as you want to save this tooth you are complaining about.

making suitable payment arrangements may be the solution to your problem. d) by controlling the financial problem: (1) dividing the treatment needed (2) arranging suitable payment plan. e) by showing the desirability of comprehensive dentistry leading to optimum control of dental disease (1) “Story of Modern Dentistry” “Mr. we are interested in putting dentistry within a patient’s Modern reach. we don’t know the extent of the damage in your mouth.. the damage is considerable. ________. Years ago. etc. the reader will note that relaxation of the patient is accomplished by assuring him: a) that his complaint will be treated quickly as possible b) that you understand and sympathize with him in his financial position Through these steps the patient is put in a state of mind receptive to further education. In which case. so that she didn’t have to worry about going into debt. Later she is going to have the rest of her work done.” mouths until they had a toothache or other annoyance. Tel “Story of “You see. in view of all these conditions now apparent. we can already conclude that considerable treatment may be necessary. Even though I do not yet know the specific treatment which will be best for you.” (Continue with “Story of Modern Dentistry. I can see that the fee will be rather large. resulting from missing teeth. The education itself is then continued thus: c) by showing an example of a case similar to that of the patient: (1) illustrating cause and effect of damage (2) indicating advantages of thorough examination. people didn’t know this. on the other hand. and therefore neglected their Dentistry. this complete diagnosis of your mouth will help me determine not only what may have helped cause the cavity but also which other conditions urgently need treatment.” . to avoid as far as possible still more serious trouble.when the treatment was completed her payments were finished.” Chapter 6) To summarize. 8. (3) Ascertaining whether the patient understands the need for a complete diagnosis as the first step toward determining which conditions most urgently need attention. It mat be very slight. “If. too. But whatever it is. “That’s how we helped this patient. I am sure we can arrange payments so that it will be no hardship to you. However.

Indicate that “Today we have new ways of meeting these difficulties. 3. because occasionally people have had will be treated and trouble with it. However. so also it has progressed along preventative lines.Patients statement “I’d like you to examine my teeth. fixed bridges require cutting into sound teeth. which allows for easier cleaning. Many difficulties “As a result of the progress that dentistry has made. They had the bridge-work removed and in some cases refused to have any further bridge-work. This helps to prevent decay from stagnating food particles. clasps can be made thinner. “ Dentistry has developed new techniques for removable bridgework as well. We Modern dentistry examine more thoroughly. it is always possible for cavities to start in these supporting teeth just as in any other part of the mouth. corrective. “Of course. of course. I can understand how you his complaint feel about bridgework. we are now able to overcome many that you understand of the difficulties patients have had. Fifteen or twenty years ago a patient paid little . Removable Bridge-work Has been Improved. thereby spoiling them. Assure patient “I’ll be glad to examine your teeth. With newer Materials. it used to be difficult to fit bridges properly down near the gums (show unsatisfactory bridge on radiograph) As a result. That is why it is important for the patient to be extremely cooperative and return for periodic examination. “However. and the teeth began to decay.” 1. In the first place. fixed With fixed bridges. and have better materials. and less noticeable. People wearing such bridges experienced bad tastes and odors. but don’t talk to me about bridge work. which are. “Just as dentistry has made progress along these technical lines. so that they no longer push food between the opposite teeth. before considering different types of bridgework. so that if they occur they can be taken care of as soon as possible and thus prevent the breakdown of the bridge. Then the gum became irritated and sore. lighter in weight. Now removable bridges can be designed and constructed so that irritation of the gums is for the most part avoided. it is even more important to determine whether or not it is needed. I don’t want any false teeth. the clasps on removable bridges wear out teeth. secondly. Bridges can now be made to fit like this (show radiograph of satisfactory fixed bridge) Notice how the original shape of the teeth supporting the bridge has been restored.” 2. “For example. his attitude. have new techniques for making Has resolved impressions. food collected under the bridge and around the teeth supporting it. Thus patients no longer have the difficulties they used to complain about. Observe the space left between the teeth on the bridge. especially if they cooperate by following carefully all instructions regarding the care and use of the appliance and if they return periodically for re-examinations.

” . we shall be very careful to test the effectiveness of the anesthesia as you are treated. they always hurt me. “Years ago we didn’t know about these things.” (continue with “Story of Modern Dentistry. then. More complete techniques for meeting the statements “You have to cut into good teeth” and “Bridge-work makes a person feel old” are given in Chapter 31. we will be able to determine the method best suited to your needs. The education.attention to his teeth until he had a toothache…. or perhaps fill the tooth. Whatever method is used. because the dental profession has developed a number of new methods for controlling pain. d) by indicating the patient’s responsibility (1) to follow instructions carefully concerning care and use of the appliance. is carried on as follows: c) by pointing out that the dental profession has developed new methods for controlling pain.e.. and what did the dentist do? Usually he had to remove the tooth. (2) To return promptly for re-examination. i. b) That you will be extremely careful to test the effectiveness of the anesthetic as you proceed. d) By indicating the necessity for exploring the patient’s health and past dental history. the reader will note that relaxation of the patient is here accomplished by assuring the patient: a) that his complaint will be treated as quickly as possible.” Chapter 6) The reader will observe that relaxation is accomplished by assuring the patient: a) that you understand and sympathize with his fear of pain.” Chapter 6) To summarize. Then he had to go. relieve the pain. radiographs of castings. b) that you understand and sympathize with his attitude toward bridge-work Once the patient is relaxed he is in a receptive state of mind to further education. “I don’t like to go to the dentist.” (continue with “Story of Modern Dentistry. which is accomplished as follows: c) by indicating the progress that the dental profession has made in solving the difficulties that may be on the patient’s mind: (1) Examples of satisfactory and unsatisfactory bridge-work are shown (2) Explanation of precautionary measures taken during construction. e) By telling the “Story of Modern Dentistry.” “I’m glad you told me about that. etc. and therefore a person’s fear of pain often kept him away from the dentist until he had a severe toothache. “By exploring into your health and past dental experiences.