The future of preventive dentistry

Have you ever heard of the Institute for Oral Health? This organization identifies best practices in oral health and then encourages collaboration between dental insurance companies, physicians, dentists (private practice, academia and public health) and researchers to benefit the public and the profession. This year’s annual conference theme was on preventive dentistry and I was lucky to attend.

From the 200 attendees at the conference, I met only one other dental office manager – so I thought it might be worthwhile to share an office manager’s perspective on the future of preventive dentistry.

At this conference, a vision was shared that although everyone knows dental infection is an entirely preventable disease, we truly can work together to eliminate this disease – just like polio in the past. The President of the ADA challenged the group to set a timeline – let’s eradicate dental disease in the U.S. in 10 years! The first step to making this a reality is to focus on diagnosing and treating the disease in addition to treating the symptoms (fillings, crowns, replacing missing teeth).

To diagnose a caries infection, you use a risk assessment. Part oral health habits and lifestyle questionnaire, part saliva and bacteria evaluation and part clinical exam, this risk assessment will serve to let your patients know if they have this disease today and what risk level they are for developing it in the future. The ADA has published a caries risk assessment form on their website and Dr. Kim Kutsch, CEO of CariFree, shared his version at the conference as well at http://www.carifree.com/dentists/downloads.html.

As dentistry starts to use these risk assessments in private practice, I can see three major opportunities for office managers to help patients and their practices:

• 1. Documenting risk assessment results for insurance payment. Right now, documenting caries risk isn’t part of the insurance claim form. As insurance companies begin to require this information to identify what benefit level the patient receives and process the claim, office managers can figure out how to document the risk assessment in our computer systems. The benefit to the dentist is that if a patient has a documented high risk of decay, the patient will receive more benefits than someone who has a low risk. Practices that document risk assessment will receive more accurate insurance reimbursements.

• 2. Documenting clinical results. Insurance companies already create a profile of dentists to identify outliers (the dentist that submits far more crowns than a normal practice) so let’s turn this idea on its head: office managers could track how successful the practice is at moving patients to the lowest risk category – and this can become a successful marketing communication.  “Come to our practice because we have documented success at helping people stay healthy!”

• 3. Communication skills. There was lots of discussion at the conference on how to talk with patients in a way that allows them to choose to change their oral health behavior. Dentists and clinical staff are not trained to talk and connect with people, so this is a separate skill that the office manager can take over. Think about how this would work in practice. When a patient arrives for a cleaning and exam appointment, the office manager would simply hand the patient a questionnaire (along with the standard health history) to document the patient’s oral health habits and lifestyle (i.e. smoker). After the clinical exam where the hygienist completes the rest of the questionnaire, the office manager sits down in a consultation room and shows the patient the results of the caries risk assessment. The office manager can take the time to really connect with this patient and review the treatment choices of the infection (from doing nothing to conservative or aggressive treatment of the decay problem) as well as reviewing the treatment plan (fillings, crown, etc.) and tie it all into the patient’s motivation.

As caries risk assessment becomes more popular in dental practices as a preventive approach, there will be many changes. Dentists and clinical staff will expand their focus from treating symptoms to talking about the disease of dental decay and helping people understand that they can stop this disease. Insurance companies will begin to reimburse based on the patient’s level of health. Office managers can play a major role in preventive dentistry by managing documentation of risk assessment results for insurance payment and dental practice marketing as well as developing people skills to connect with patients trying to fight this disease. As office managers help to make a difference in people’s lives through preventive dentistry, we all win.