EP08: One Step to Improve Your Patient Education Tomorrow

Are your patients coming time and time again needing the SAME oral hygiene instruction? Are you tired of feeling like you are lecturing patients all day long? During this podcast Wendy discusses great new ways that we use to educate in ways that patients WILL learn and WILL improve and will no longer be overwhelmed by the oral care aisle at the grocery store. Listen in and learn how to create patients that leave happy with their improvement and providers end the day happy with increased overall hygiene case acceptance and production.
Scroll to the bottom of this post for the science referenced in this episode!

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EP08: How To Improve Your Patient Education Tomorrow Transcript:

S1 00:02.413 [music] Welcome to the Double Your Production podcast with the Team Training Institute, the one place designed for dentists and their staff who want to grow their practices by following in the footsteps of those that have done it or in the trenches who know exactly what you’re going through. And now, your leaders, the stars of the podcast, Dr. John Meis and Wendy Briggs. [music]

S2 00:28.814 Hi and welcome to another Team Training Institute podcast. Today we’re here with Wendy Briggs and we are going to be talking about some of the more recent current events here in the hygiene field. So one question that we get a lot is how do we as hygienists educate our patients? I know that Wendy brings up pretty often one situation where a hygienist miseducated a patient. Wendy, do you want to give us a little bit more information about that?

S3 00:59.374 Yeah. We have talked for a long time about the importance of having a guilt-free, lecture-free zone. And one of the things that hygienists kind of get a bad name for, or a bad reputation about is giving patients a lecture. There was actually a blog post that went viral a few months ago from a patient who was disgruntled, is a probably good way to say it. And so the patient was basically ripping apart our entire profession. I mean, truthfully that’s what was happening. And basically saying, “No matter what I do at home, it’s never enough for you.” They were super frustrated, really just done with having to go and have this lecture every time they go to the dentist. And so that’s a problem, I think, for our profession because sometimes we certainly have good intentions. We’re trying to educate our patients. But we may not be handling it in the most tactful way.

S3 01:52.848 I used to work with a hygienist before I went to hygiene school when I was an assistant, that used to order– intentionally she would order clear saliva ejectors so patients could see all of their own blood. And she felt like that would help them learn that they needed to improve. Well, I think it really provided the opposite effect. It made patient retention difficult and patients don’t like to be guilted or shamed. They know what they’re not doing. And so we’ve got to be careful about how we approach patient education, and we have to try and make sure that we come from a guilt-free, lecture-free zone and we come with the right intentions. We are trying to help our patients improve, but showing them what they’re not doing, I just have found that’s not necessarily always received in the best possible way from the patients themselves.

S2 02:44.269 Right. So as a hygienist, I mean, we always want to help our patients like you said. And it’s frustrating when a patient comes back time and time again and you’re treating the same disease over and over and over. So from your standpoint as a professional, how did you go about correcting or improving your patient education?

S3 03:07.317 Well I think a big part of it is the technology that we have. We talk a lot about the need for utilizing technology on the restorative side, but we love to see hygienists using technology on the hygiene side as well. And so your intraoral cameras can be a really powerful tool to utilize here. We love the technology behind an intraoral camera made by a company called Acteon. It’s a SOPROCARE camera and it has a PERIO mode setting. And when you use that specific wavelength of light in this PERIO mode setting, it highlights for the patient to see plaque, tartar, or calculus, as well as inflammation. And so they can actually see where the problem areas are, which is the first step, I think, in acceptance. But we also have to understand that not every patient is going to respond well to the same exact strategy. So if you lay an entire tray, for example, of home-care implements out and let the patient choose what they think they like or what they would use, they’re all going to choose something a little bit different. So I think that’s a mistake that we tend to make as hygienists, is we’re trying to get all of our patients to do one or two key things instead of really opening a conversation about, “You know, you mentioned that you’re not a daily flosser. What do you do? Could you envision yourself doing something instead? Here’s a whole bunch of different things that we think can be impactful. How can we help you in this way?” And maybe just open the conversation about what the patient will do.

S3 04:30.558 Another thing that we do is we strive never to talk about what the patients are not doing. Instead, we talk about getting them better tools and empowering them with better equipment and better products to help them achieve a higher level of success. So we talk about this at length when we go into the five steps to increase case acceptance for perio. In the context of those five steps, we actually go through, “Here’s three things we need to do to treat this infection. We need to do gum infection therapy, which is a more advanced treatment than you’ve ever had before. And the very next thing we need to do to treat this infection is we need to get you better tools.” That’s part of the conversation that we teach hygienists to have with the perio patient, but we can certainly use the same language with the recare patient. So we can talk about getting them better tools.

S2 05:17.028 Right. So kind of shifting the blame, necessarily, from them onto more trying to figure out a different strategy for them to use personally.

S3 05:29.173 Yeah. We don’t talk about what they’re not doing. Instead, we talk about what maybe using different implements or different tools could do for the impact. So we’re talking about the impact that better tools could have rather than what they’re not currently doing today. And so when we start the conversation that way, we have found patients a lot more receptive, a lot more willing, and they want to improve. But they just know– it’s like going to the weight-loss doctor. Nobody wants to go and that’s why Weight Watchers does so well and some of these organizations that hold you accountable. But, in a way, that’s never going to work, that strategy, unless the patient truly wants to lose weight–

S2 06:05.879 Wants to improve.

S3 06:06.439 –and is committed.

S2 06:07.303 Right. And you use the intraoral camera as a way to motivate them to want to improve.

S3 06:11.585 Well they need to see what we see. And a lot of times patients can’t see it, or they don’t, or they won’t. So when it’s big as life on that screen and they can see the plaque, and the tartar, and the inflammation, and we can talk about the consequences of this infection if we don’t turn things around, then I think they understand the why more. I think a lot of times, that’s what patients are missing. They’re missing why should they step it up at home, or why should they focus? You know, they’re so busy. And what kills me is the patients that come in and we’ve talked about power brushes and floss and all of that for years, and now, all of a sudden, they’re spending 20 minutes a day oil pulling or some ridiculous thing. And I’m like, if you would give me 20 minutes a day, we could completely change your life. But they won’t. Right? They’re too busy to do all of that. So the key is, in my mind, the whole trend, all these brushing with charcoal, oil pulling, and all these crazy trends that happen, in a way, I think that’s not a bad thing. I think we can use that to our advantage because it shows that consumers, our patients, are looking for solutions. Now let’s just help them find solutions that we know work.

S2 07:12.491 Right. That’s awesome. So you, personally, what kind of tools or products have you found throughout– I know you speak around the nation and to offices all over the place. What kind of tools are you finding are having success most in other offices?

S3 07:30.670 Yeah. So that’s a really good question. So I could teach a six hour course on the science behind home care products and the entire array and all of the choices and all of the products out there. But it can be overwhelming for patients. I don’t know the last time you’ve gone to the aisle, the home care, the tooth oral home care aisle at Target or Walmart. It’s forever long. I mean, there’s so many different options out there and no wonder it’s overwhelming for patients. And no wonder they’re saying, “Well, I just buy this at the grocery store and that’s what I use.” Well, instead, we found that there’s a couple key things. And again, I could go on and on, but we first focus on power brushes. They need something more than a mechanical manual toothbrush. A manual toothbrush essentially is using the same technology that we’ve used for thousands of years. It’s essentially a stick with some bristles on the end of it, right? We show a really clever commercial created by Sonicare during patient education that helps them see the need for investing in technology in their mouth. And so, I tell dentists and hygienists, “I don’t really care what brand of power brush you use as long as you have something available for patients.” What I really want us to see is I want to see us recommending a power brush that they can’t find for less outside our office. And so I love Sonicare technology. I use a Sonicare. But I also don’t appreciate the fact that patients will go to Costco and be able to buy it for a lot less than they can get it from us. Now I know the professional model’s supposedly better and has more bells and whistles, but patients don’t get that and they don’t see that. They see, “Oh my gosh. I paid $120 at the dental office and it’s $69 here.” So that part bothers me about Sonicare. Oral-B has some great implements. What’s funny is I said I use Sonicare, but I also use an Oral-B Triumph. I have three power toothbrushes that I rotate with. Call me crazy [laughter]. But I know they all do different things. So the Oral-B has a beautiful program called the Test Drive. And we hear from hygienists, yourself included, that they love the Test Drive.

S2 09:29.985 Right. Yeah, I love the Test Drive.

S3 09:31.963 So you tell us about how that’s working with your patients.

S2 09:34.979 Well, me, as a practicing hygienist, I use the Test Drive fairly often when I’ll ask patients, “Have you ever thought about using a power brush?” And they all say, “Oh yeah, I’ve thought about it.” And I say, “Have you ever tried one?” And more often than not, I’ve actually been surprised at how many people haven’t even tried one before. And so, I just got done telling you, Wendy, that I feel like that’s my way of selling toothbrushes. It’s overwhelmed with the amount of people who once try it, they say, “Oh yeah, I really like that. How much is it again?” and then I get to go and explain exactly what it does, and how much it costs, and things like that. And more often than not they’ll buy one.

S3 10:11.995 Right. Yeah, for sure. And the statistics show that 40% more sales if you actually are utilizing the Test Drive program through Oral-B. And I also love the fact with Oral-B is that their professional pricing is very competitive, so we can say to patients, “The main reason we have these power brushes here is because you’ll save. You pay less here than you’ll pay at Walmart.”

S2 10:30.567 I’ve had patients pull up Amazon in the chair and say, “Oh yeah, it is cheaper here,” and they go home with one.

S3 10:36.774 So that’s the thing. Consumers are smart. And if we’re trying to build trust in these relationships, the worst thing we want to do is overcharge them for a toothbrush that they can find less elsewhere. So that’s something that’s important to me. There’s also another new player in the market that I really, like and they aren’t available at Amazon or over-the-counter, at least in my understanding. They go direct to dentists and hygienists. And that’s a company called DentistRX. And they have a variety of power brushes, just like any other company. And I’ve tried some that I’m okay with, and I have another one that I really love. That’s one of the ones that I use. So do your homework. Find out. I like to see a practice have an array, something to suit every budget. We joke with patients that we have between the Ford and the Lexis. What do they drive? What do they want? Do they want the basic entry-level model or do they want something with all the bells and whistles? And what best suits their budget. So a power brush is probably the most important thing that we start with.

S3 11:31.709 Then the second thing is mouth rinses. There’s so many studies that prove the value of mouth rinses, antimicrobial and antibacterial mouth rinses with oral health. And so in recent months, there’s been a few studies published that have caught a lot of hygienists attention. There was one study published in The Clinical of Microbial Infection Journal in 2007 that said– it was a study trying to decide, are there clinical benefits to mouth rinses? And what the study, the published results were, the balance of risk and benefit is firmly in favor of the continued use of mouth washes containing active antimicrobial agents. So for many years in dentistry, the gold standard of antimicrobial mouth rinses has been chlorhexidine. But recent studies have shown that there’s some new concerns with chlorhexidine, and what we’re seeing is we’re seeing a broad spectrum biocide. Now, certain bacteria are developing tolerance and resistance to chlorhexidine. So this has been a long gold standard for so long that now we’re seeing – especially when bacteria are growing in biofilms, when they succeed in forming a biofilm – they have mechanisms of antimicrobial resistance in this bacteria. And so that was published in the Antimicrobial Agents and Chemotherapy Journal in October of 2014. And what they’re saying is some bacteria may either be intrinsically resistant to chlorhexidine or have induced mechanisms of resistance due to phenotypic and genotypic changes and are resistant in both long-term use and high concentrations of chlorhexidine, especially gram negative bacteria appear to be highly resistant to chlorhexidine. So this is a problem. Another problem with chlorhexidine as well is it was published in the Journal of Dental Sciences in 2014 that chlorhexidine demonstrates cytotoxicity potential, so, subsequent cell death. So here we have this broad spectrum antimicrobial rinse that’s super good at killing the bugs, but it also kills off new cells. And so when we share this research with dentists and hygienists alike, there’s a small amount of panic because for so many years, we’ve used these products exclusively with infection. And so what we’re finding is we’re finding a need for additional other resources. And I don’t have time to get into too many details today. Maybe you want to a separate podcast.

S2 13:53.639 Yeah. Let’s do another podcast about–

S3 13:55.532 On the essential oils products, but I think it’s really exciting. Many of our clients now and a lot of the times that we lecture on it, we talk about a product that we use exclusively for perio called Essential Smiles. And so if you don’t want to wait for the podcast about that research, you can certainly go to www.essentialsmiles.com and register for that and, we have a team of hygienists that will do a lunch and learn where your team brings lunch in and you can earn a CE credit learning about the science behind this product line and all essential oils and how they work well in dentistry. Because I’m sure many of you know essential oils have been used in dentistry for more than 100 years successfully. And so the bacteria that have developed tolerance resistance to chlorhexidine do not appear capable of developing tolerance resistance to essential oils. And so some type of antimicrobial mouth rinse that’s beneficial is super important. Before I started using any essential oils-based mouth rinses, we had success with .64 stannous fluoride rinses. So just use something that can help keep the bacteria under control.

S3 15:01.220 The other thing that we talk about as well as fluoride products, patients that are high risk for decay, we like to see them using some kind of 5000 part per million fluoride formula. This could be a toothpaste. It could be a rinse. It could be a lot of other things. But we love to see patients, especially those that are high-risk for fluoride, also using fluoride products at home.

S2 15:17.436 So that’s all really good information. Now, when you do go and you ask these kind of questions, what kind of patient response are you getting?

S3 15:26.793 I think patients are very receptive. I think they typically want to improve, especially when we present it in the way that we do, that, “Hey, we just want you to have the best outcome and these tools are proven scientifically to really help.” So we’ve also found it really helpful to just have bundles, have a basic and a supreme package so that they can choose which suits their budget. And if they have periodontal infection, a lot of times we’ll include these products in their estimate for the treatment. So it’s just a part of the treatment that we’re recommending for them. And so I think we just have to, as hygienists, we have to recognize that we are partners with the patient, and we want them to have the highest level of success, but we also don’t want them to feel guilted or shamed. We want them to want to come back and see us. We want them to come back and bring success stories. They get excited about the products. And that’s really our role is to help inspire the patients to choose more.

S2 16:17.375 Right. Yeah. It’s our job to help them improve and they need to want to improve, which is awesome. Well, what a good message. We’ll put some of that science online. You can find that at www.theteamtraininginstitute.com. And we’ll have some goodies there from this talk today about products. I think as a hygienist, it’s always really beneficial to have someone who, like you, is out there finding the science for us and allowing us to be pioneers and to be using the latest and greatest technology, as well as products, for our patients. So I appreciate that.

S3 16:57.876 Yeah. No problem. And I’ll create a PDF with some of the slides of the chlorhexidine research because that’s typically what most people ask about. They want to see that and dive into that a little bit on their own. So we’ll include some of the scientific references, the studies that I referenced today, so that you can do your own homework.

S2 17:12.126 Yay. Okay. Well, one more time, www.theteamtraininginstitute/podcast. And everything should be up there for you. Thanks so much, again, Wendy. We so appreciate hearing you today and look forward to more podcasts. So look for those.

S3 17:26.532 Thanks again, Katie. [music]


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