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August 15, 2008

By Robin Bonvechio and Scott Lawrence, DDS

During the 20 years we have worked together, there have been many changes in dentistry. We have supported each other as we have worked together to adapt to new challenges every day.

The adoption of new technologies and techniques was difficult at times, but we are happy to say it has brought progress to our profession. We are now able to work much more efficiently, and make better use of our disposable resources.

But most importantly, we are able to better serve our patients and their needs--dental and otherwise--since they are much more than just teeth to us.

This article explores one of the technologies that helps us provide higher quality care to our patients--patient-education software. In recent years, patient education systems have transformed the practice of dentistry and the way we treat patients.

Patient-education software: A comprehensive experience
The most important result of technological advancements is the increased quality of patient care. Patient education and digital imaging are areas that have evolved immensely. They clearly play a significant role in how we interact and care for patients.

Working in a rural community, one of our main objectives is to heighten patients' awareness of the importance of regular dental care, especially regular prophylaxis, X-rays, and examinations for their dental health, as well as their overall health. Arguably, the most important tool that has transformed the way we relay this message to our patients is patient-education software.

We use CAESY Patient Education Systems in the operatories and reception area. The variety of presentations helps us demonstrate diagnoses and explain treatment options to give patients a better understanding of what we will be doing. The programming in the reception area expands patients' knowledge of dentistry and spurs many conversations about the latest topics related to esthetics and oral health. To follow are a few examples.

In the operatory
We have found digital images and radiographs to be instrumental in the diagnosis of patient conditions. An intraoral camera takes just a few moments to capture images of the patient's mouth and the issue at hand. We can then pull the images up on a screen in the operatory and discuss the images with the patient chairside. This makes the issue and diagnosis a reality for the patient, especially if we can point out what is happening and demonstrate the reasoning behind symptoms.

We also use the video camera for patient education. We have started to probe pocket depths with the video camera in patients' mouths so they can watch the probe going down to the 5-, 6-, and 7-mm pockets. They can see the blood and the exudates, and their fascination is evident by the looks on their faces. When a patient sees his or her mouth on the monitor screen, it's remarkable how quickly the patient wants to begin treatment.

Then, using CAESY, we can show patients a video that gives a visual and oral explanation of the treatment process. Through photos, they learn exactly what it is we are going to do.

Gone are the days when we hold the little films up to the light and try to show the patient the problem. Today, on the "big screen," they are awed. As with many items, one has to "see it to believe it." This opens up conversation with the patient. We want to make sure their questions are answered and that they are comfortable before we proceed with a treatment plan.

Another example is root canal treatment. It's common for a patient who needs a root canal to say, "I don't know what that is." In seconds, we can have a radiograph of his or her mouth on a TV screen in the operatory with minimal radiation and no time spent processing. If a second or third X-ray is required, it takes just another few seconds to capture it.

Recently, we have seen a new wave of implant therapy. Patients commonly ask, "Is that where you screw the tooth into the bone?" When the pictorial is put on the screen, it illustrates what the implant is, what it does, why it has to knit to the bone, how the area is revealed and the abutment is placed on the implant. All of this is in living color. We have yet to see a patient who has been able to conceptualize this after seeing the pictures and step-by-step explanation.

When patients see the implant placed and the crown or bridge placed, they can envision the restoration of their chewing function. In these instances, we witness education jumpstart motivation! Our main intent is to show patients that we care about them as people, then to educate them in a caring way. Patient-education technology has so much more of an impact than talking or using a drawing out of a manual.

In the reception area
As an adjunct to our treatment-room technology, we play the CAESY Smile Channel video loop in the reception room. It is a nonstop presentation that includes our personal practice photos. It opens dialogue with patients. Many ask if we can explain what they just witnessed on the waiting room TV.
This has become increasingly successful for elective cosmetic cases.

One of our favorite things is to show a picture of a finished case of veneers or full crowns on anterior teeth since we see so many patients who say, "Can you do something about my ugly teeth?"

Recently, we prepped a six-unit bridge for a patient and an eight-unit bridge for another patient. These cases literally sold themselves. When patients see a finished product, it is truly a "done deal" and they become another happy case.

On the flip side, if the treatment is never completed, it's still a "win-win" situation because we have a patient who feels cared for and educated. Maybe some day they will decide the time is right and will have the treatment completed.

Follow-up
We also use our patient-education software to conduct follow-up with patients, and to provide them with takeaway materials, often in the form of before-and-after images. While patients are in the office, we can pull up a CAESY presentation or image gallery and show them examples of before-and-after photos.

We also have archives of digital photos that we have taken of patient treatments. It's quick and simple for us to print these before-and-after images and give them to the patient. They serve as a helpful tool to keep pending treatment in the patient's mind after he or she leaves the office.

With these images sitting on the kitchen counter or tucked into a briefcase, they remind patients to think about treatment options, come up with questions, and discuss it with family members. We allow them time to consider and reflect on, "Do I want beautiful teeth?"

There is also a feature called ShowCase within CAESY that allows us to create practice-branded materials. This is helpful, but we find that the before-and-after images are enough to get patients asking questions and to follow up on treatment recommendations.

Looking to the future
As we continue to incorporate new technologies, our goal is to provide the best service for each patient, knowing that each person has a different need. Patient- education software has made our job more effective since we are better able to educate patients through technology. This makes the explanation process easier and better for each patient. We are trying to make dentistry a valuable priority for patients.

Today, more and more patients are aware that dental health, specifically their periodontal health, is linked to their general health. This makes it even more necessary to maintain good oral hygiene. The harder we work to embrace technology and make our jobs as dental professionals easier, the happier our patients will be, the more they will appreciate their oral health, and the more likely they will become lifelong friends of dentistry.

Image 1: Before-and-after image. In this case, there was a large periapical abscess and an old silver point in the tooth. In the top photo, the point had been removed and a working length X-ray taken (4-second development). The bottom picture is the finished root canal treatment. Patients see these photos developed right before their eyes, and are quite amazed.

Image 2: Before-and-after images. This patient let her dental health go for a long time due to other health concerns, but still wanted to try to maintain her teeth. After seeing the after (lower) picture of her completed treatment, she intends to stay faithful to routine dental care.

Image 3: These five intraoral photos were taken in 15 seconds to help a patient decide between restoring or removing six remaining lower teeth. The patient is a 55-year-old man who wears a complete upper denture with which he is satisfied. A meeting with the patient included a discussion about repairing his lower remaining teeth. Before his visit, the patient decided that he wanted these teeth removed. The condition of the patient's teeth was addressed by using digital panoramic and intraoral photos. Subsequently, the teeth were removed, the ridges were prepared for lower dentures, and a denture made.

Image 4: These four working-length films were taken in one minute with no processing required. With the speed and accuracy of digital X-rays, as few or as many images can efficiently be captured to augment a discussion with a patient.


Image 5: Before-and-after images provide a basis for discussion of the entire treatment process and the patient's reaction to the final outcome. This is an infected silver point root canal that had been asymptomatic for more than 30 years before flaring up. The top photo is the silver point in place. The lower photo is the completed endodontic treatment. This patient went on to have a new eight-unit bridge placed. The patient then had the lower teeth lightened.

Bios
Robin Bonvechio has more than 30 years of experience as a dental professional. In those 30 years, she has worked in all areas of the practice--from seeing patients, taking X-rays and doing lab work, to running the front office and managing the day-to-day workings of the practice. For the past 20 years, she has worked as a dental assistant with Dr. Scott Lawrence at his practice in Newcomerstown, Ohio.

Scott Lawrence, DDS, owns general dentistry practices in Newcomerstown and Gnadenhutten, Ohio. A 1985 graduate of the Ohio State University College of Dentistry, he has nearly 25 years of experience in the dental industry. Dr. Lawrence can be reached at Scott Lawrence.

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