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Debbie Seidel Bittke

What Secrets Are You Keeping from Your Dental Patients?

What Secrets Are You Keeping from Your Dental Patients?

9/13/2019 6:45:42 AM   |   Comments: 0   |   Views: 41

As you read the title of this weeks blog you may wonder, “Debbie, what I mean by secrets?”

What I over hear in a dental office happens too often

For most of my dental career about 35 yrs now,  I STILL hear comments like, “He (“He” is referring to a patient) just got kicked out of his house! He is going through a very hard time in life and the last thing he needs to hear is that he has gum disease!”


It’s not always that exact line but NOT telling patients what they need to have a healthy mouth is something I have heard for too long.

I hear so many excuses from dental professionals who don’t want to tell their patients they have a “hole” in their tooth. These dental professionals are hesitant to tell their patient that bleeding gums mean gingivitis or gum disease. 

Many dental professionals around the world are more comfortable waiting to tell the patient the truth about dental disease.

What secrets are you keeping from your dental patients?

These secrets began when I had my first position as an employed dental hygienist.

I had no idea that working in a capitation dental office meant we were not allowed to tell patients they had gum disease, that they needed to schedule for scaling and root planing, aka: “Gum treatment.”

That position as dental hygienist was quickly put to a halt when I was not willing to NOT tell patients the truth about the health of their gums!

Now as a dental hygiene coach and consultant I hear dental hygienists say they can’t tell patients they have gum disease. It’s time to put this elephant in the room to rest!

Supervised Neglect

Dating back to 1984, my first position as a dental hygienist (As I write about above), I was not willing to NOT tell the patients they have a healthy mouth when in fact, the truth was, most of these patients had serious advanced gum disease with radiographic bone loss.

The doctors/owners of this dental practice literally laughed when I mentioned NOT telling patients they have periodontitis is called supervised neglect

I was quickly dismissed from my position as a hygienist and as you know, I have moved on in life to be an advocate.

Since this time 35 yrs ago I have been an advocate for dental professionals to share the message with their patients that “optimal oral health will lead to a healthy and longer life.”

As you search the internet and your state board of dentistry for the definition of supervised neglect, you will discover that not providing treatment greatly outweighs overtreating your patient.

Telling the Truth

A prudent goal for dental professionals should sbe to save patients from pain & suffering, spending a lot of money treating disease and time in the dental/medical office.

What makes the difference in your dental practice and your patients will be engaging your patient during the exam and allowing your patient to know the following:

  1. “What you are doing” before you begin your exam     
    1. For example, Hygienists will say something like this to patients” “ Mr. Smith, today I will be looking for any abnormalities inside your mouth. I will look at the hard and soft tissues with my special light (AKA: OralID® ) and next I will look at the the health of your gums. Susan is our dental assistant who will be in here shortly. I will call out some numbers and Susan will type them into our computer.”
              “I want you to listen to the numbers because at the end of the exam I will ask you what was the highest and what was the lowest number I called out.”
  3. Talk to your patient about “what you see.”
  5. Next, have a conversation with your patient about what you both “see” during the exam.
  7. Create a partnership with your patient.     
    • Let your patient tell you what they heard you say during the exam.
    • Become the patient advocate.
  9. Take pictures of what you “see.”     
    • Use your intraoral camera to take pictures of your periodontal probe (aka: “ruler.” Hint. We probe aliens not human patients. lol) in a deep pocket, take a picture of supra-calculus and bleeding gums. Take pictures of discolored teeth, holes in your patients teeth, crowns and areas where they have missing teeth. Also take pictures of chipped teeth, discolored teeth and malocclusion.
  11. Proxemics Matter.     
    • When you are talking with your patients always have them seating upright and positioned knee-to-knee and eye-to-eye.
    • It’s scientifically proven (called Proxemics) that sitting your patient upright and within arms distance will help your patient to make a better decision.
  13. Take away any discrimination when talking to your patients.     
    • Tell your patient what you “see” in their mouth
    1. Eliminate the thoughts that you “think” they can’t afford what they need.
    3. Eliminate the thought that you will NOT tell your patient what you “see” in their mouth because you know they are having a difficult time in their life personally (ex: going through a divorce or lost their job, etc.).
    5. Eliminate the fear of telling your patient they have gum disease or gingivitis because they have been coming in religiously every six months since 1980 (and suddenly today their mouth does not look healthy).
    7. STOP the desire to NOT tell your patient they have gum disease, gingivitis or need restorative treatment because “You think” their insurance may not pay for what they need.
  15. Bottom-line: “TELL YOUR PATIENTS THE TRUTH.”     
    1. If you feel uncomfortable and don’t have a solid plan to communicate necessary treatment to your patients, I do want to suggest you contact an expert who can offer support for you and your team.
    3. Your patients will be happy.         
      1. Your patients will live a longer and healthier life.
    5. When you are able to effectively and elegantly communicate what your patients need in a way they will “want what they need” its very possible you will have raving fans.         

Take a look at your case acceptance rate.

Do you have 80% of your patients accepting treatment?

Take a look at your percentage of adults who have completed periodontal treatment.

  • Are 30%  and more of your adult patients enrolled in periodontal maintenance and periodontal treatment?

IMPORTANT FACT. The CDC states that over 42.7% of Adult Americans (30 yrs of age and older. Research found here) have some form of periodontal disease.

How often do you treat patients (young: under 20 yrs old) and adults for gingivitis?

We know that treating disease early will put a halt for your patients spending money and time treating disease.

Please reach out to an expert if you do not currently treat patients for gingivitis and even cavity prevention (We are happy to share the most recent CAMBRA protocols with you), etc.

How can we help support you and your team to elegantly communicate to your patients “what they need?”

We are happy to help you and your team! Just drop us a line for a FREE Coffee chat.


Debbie Seidel-Bittke, RDH, BS is founder and CEO of Dental Practice Solutions. Debbie is also a former dental hygiene program director. Her expertise is optimizing the hygiene department by taking a total team approach; including the doctor as the leader.
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