Turn Frightened Dental Callers into Lifelong Patients IV Sedation Adds Profitability Tools for the Future of Your Practice

William J. Moorhead DMD

Treating fearful dental patients can be very rewarding. The average dental fear patient needs over $2000 in dental work for every year they haven’t seen a dentist. Since many of these patients have avoided a dental visit for over a decade, case sizes quickly mount up.

Sedation has proven to be an effective tool for fearful patients, patients with strong gag reflexes, special needs patients, and lengthy procedures. With the popularity of dental implants rising, there is even more call for IV sedation in general practice.

Dental fear patients offer a unique opportunity but also can create unique challenges to your practice. More than one in five avoid dental care altogether due to fear and anxiety – that’s over 60 million Americans. When anxiety, stress, and fear become the dominant motivations driving your patients, it can be close to impossible for you to help your patient back to health. Practices performing IV sedation attract patients that increase practice productivity, and advance the image of a dental practice as a leader in the level of care offered in the community.

By adding sedation to your practice, your future dental practice can be transformed into a market leader. Adding sedation to your practice shows your potential patient you are better trained and ready to address dental fear – the number one problem that keeps patients away from your office.

Without the right tools, treating sedation patients can cause stress – for the patient, the team, and the dentist. Knowing what to say from the very first contact with your potential patient - on the new patient phone call - and knowing the questions to ask during the new patient interview will give you the tools to convert frightened patients into lifelong patients.

A new patient phone call with a fearful patient can be lengthy. If your front office team is short-staffed and can’t give the potential patient the time they need, you risk losing them. These patients require empathy and caring, and they need someone that will listen to their concerns and reassure them. If you are fortunate enough to have someone in your front office that has been sedated by your team in the past, these lengthy phone calls can magically be cut in half just by being able to say, “Dr. (Smith) sedated me for my work and I was amazed at how easy it was.”

Once the fear patient makes it in your office, asking open-ended questions to learn their priorities and their obstacles can be key to gaining case acceptance. Here are the questions we use in my office to improve the likelihood the patient will say “yes:”

• Ask for the chief complaint and record the patient’s exact words. You will want those exact words during your case presentation.

• “Overall (excluding any specific problems), what is most important to you concerning your teeth?” This question’s goal is to learn their motivating factors. The most frequent motivating factors are avoiding pain, avoiding tooth loss, cosmetics/ appearance, health, cost, and function. Repeating this learned information when the patient is making treatment decisions will increase your success.

• Ask a question to learn about the patient’s perceived obstacles. “As you are considering having your treatment done, is there anything that gets in the way?” For the dental fear patient, you can expect dental fear will be listed, but there may also be other obstacles such as busyness, scheduling, costs, or trust issues, which often go hand in hand with dental fear. You can only address these obstacles when you become aware of them.

• Consider taking digital photos before the new patient interview. Once the photos are uploaded to the patient’s chart, display their retracted smile photo, then ask “is there anything you would like to change about your smile?” Many patients are unaware of their cosmetic issues, and self-discovery is a valuable tool in patient motivation. Before they will consider addressing any cosmetic concerns, you may have to resolve their dental pain first so you can show them you are able to treat them comfortably

• Even though you know the patient is fearful, asking a question to learn their specific concerns will help you better know them. I like to ask “would you share with me what happened in the past that caused you to be anxious about coming to the dentist?” If you and your team have tools to address their specific concern, let them know up front. For instance, injection pain can be decreased dramatically with a dental anesthetic buffering system such as Onset®. And if you are already trained in moderate sedation, share stories that previous patients have shared with you.

• Ask questions about pain or sensitivity to find out additional information beyond the patient’s chief complaint. Like earlier, do your best to record the patient’s exact words, as they can be strong motivators when presenting treatment.

• Consider asking questions about bite related issues, sleep apnea screening and caries risk assessment.

• Last of all, apply principles of personality assessment surveys, such as DISC, to learn how the patient makes decisions. Patients that are direct/assertive (classic “D” and “I” personality types) are more likely to want to decide that day, and your case presentation should be geared toward that. Conversely, more indirect/non-assertive/passive personalities (classic “C” and “S” personalities) often need time to process the data, and pushing them to make a decision can actually push them out the door.

Start using these open-ended questions during your comprehensive exams today and watch your case acceptance increase, both with your dental fear patients as well as your routine new patients.

Summary Of Patient Interview Open Ended Questions

Chief Complaint: What are your biggest concerns you want to make sure we address during your visit?

Motivating Factors: Overall (excluding any specific problems), what is most important to you concerning your teeth?

Obstacles: As you are considering having your treatment done, is there anything that gets in the way?

Pain/Sensitivity: Have you come today for the relief of pain? Are you experiencing sensitivity?

Cosmetic Goals: Is there anything you would like to change about your smile?

Caries Risk:

• What is your favorite drink?

• Do you sip on a drink frequently?

• Do you snack regularly between meals?

• Do you notice plaque buildup on your teeth between brushings?

• Do you have a dry mouth at any time of day other than while sleeping?

Past Dental Experience: What is your reaction to having dental work done? What happened in the past that caused you to be anxious about coming to the dentist?

Personality Type:

Top of Form

If we were going to do a project together, would you want to know:

• The big picture? (Personality type D or I – Direct/ Assertive)

• All the details? (Personality type C or S – Indirect/Non-Assertive)

William J. Moorhead DMD has developed and teaches systems and strategies for treating high fear patients. With over twenty years’ experience in sedation dentistry, Dr. Moorhead teaches practical ways to make sedation safe and effective in your practice.

Sometimes affectionately referred to as “Dr. Checklist,” Dr. Moorhead speaks across the United States on topics related to systems management, clinical efficiency, dental technology, medical emergencies, treating anxious patients and leadership. He is also the founder and owner of StreamDent® software.