Behind the Dental Chair - How Smart Dentists Crack the Code and Build a Dream Practice

Help Patients Control The Disease

Periodontal-structured hygiene maintenance visits allow the patient to properly control the disease and, in the event there are flare-ups (increased numbers or bleeding points), it is possible to immediately address those areas of the mouth, circumventing additional damage. This is nothing more than a race about who gets there first, the plaque or the dental team. When the patient shows up in a timely fashion for quarterly visits, it ensures that the patient, and the dental team, win the race. This ensures no further bone loss, and that’s incentive.

I have often referred in my speaking to the reduction our profession has seen through the years in restorative needs (crowns, bridges, restorations). This is not only a real phenomenon but something we have inadvertently been responsible for. All actions have reactions, and many actions lead to unintended consequences.

In 1971, the number of decayed, missing, or filled permanent teeth per child between the ages of five and seventeen was 7.1. By 2004, thirty-three years later, that number had dropped almost seventy percent, to 2.1. In 2004 those kids are now thirty-eight to fifty years old. Guess what they don’t need: Restorative treatment.

Dentistry is the only profession that does everything it can on a daily basis to deplete its own resources. Providing fluoride, sealants, and education to the population on a daily basis has severely reduced the need or demand for restorative dentistry. Before you overreact, I am not implying that these things are wrong. The use of fluoride, sealants, and education are precisely the correct way to care for our patients.

But there are industry consequences, and one most obvious is the reduced need for restorative dental services. My point here is, what better to do to compensate for those lost services than to begin treating a disease that is not only the number one cause of tooth loss but also has been linked to many other systemic disorders?

I’m asking you to continue your preventive efforts in restorative dentistry, but also to mine the true gold in your practice, which is periodontal therapy. There is enough gold in your practice’s hygiene department to literally change your life or lifestyle overnight. If you simply exist off all other practice incomes, as you are doing now, and invest every dollar generated from periodontal therapy, I dare say that within five to seven years, you could be calculating your exit strategy from dentistry.

We all have procedures and patients that cause unnecessary stress to the doctor and the staff. For example, I am not a big fan of treating pedodontic patients who run circles around my chair while I am attempting to treat them. I am not the type to strap them in to accomplish the procedure. I also don’t get excited over second molar endo; when I ask the patient to open wide, they give me a three- millimeter opening; and when I say, “Give me a big one,” they give me four. Both these types of patients today and for many years have been automatic referrals in my practice. I now refer them from the reception room, as I don’t have to put my hand in the fire to know it’s going to burn. These patients need to be referred to someone with more patience and talent than I possess. I spent many years (too many) treating these patients because I needed the income, and I’m certain they took a few years off my life expectancy. Dealing with stressful patients ended when periodontal therapy began, because I do not need to treat them in order to financially succeed. That was not true before periodontal therapy became a part of my practice.

Haven’t you ever wondered why a dentist has no desire to see the next day’s schedule? Stress kills. Not just dentists, but all of us. My point is to get rid of it by simply weeding the garden. This is not an option, however, when every patient’s generated dollars are so precious to the overall success of the practice. Once periodontal therapy arrives in a practice, those dollars become irrelevant and unnecessary and certainly not at the price of destroying one’s nervous system.

Like all of us, my life has had its ups and downs, which they say builds character, but I’d rather skip some character, if you know what I mean. In 1978, while just starting my second year in dental school, I received a phone call from my mother. It felt like one of those “Where were you when this happened” calls. I was standing in the kitchen in my basement apartment, and my mother uttered the words, “Cindy was killed in a car accident.” Cindy was my sister, one year older than me. She had been driving home from work in Carbondale, Illinois, and while trying to avoid hitting an animal, swerved and hit a large tree. She was killed instantly. I was speechless, shocked, overwhelmed, and devastated. The weight and reality of what I had just heard took me to the floor. I literally had no idea what to do. I knew the only right thing to do was to get home as fast as possible, and home was a five-and-a-half-hour drive away.

I remember getting home and finding family and friends all throughout the house, engaging in disbelieving conversation. I sat in the basement of my parents’ home for two days and kept asking, “Why?” There were three kids in our family, and Cindy was by far the most creative of all. She had an amazing sense of humor. Someone once told her about a movie that had “grossed millions.” Cindy’s response was, “Geeze, I didn’t think it was that bad.”

The days leading up to the funeral and burial were painful and exhausting. We buried her in a yellow dress, one she loved, and went home to the emptiness that all families feel at times like these. I made a huge mistake when I left to return to dental school and hadn’t given myself sufficient time to grieve. Dental school took on a life of its own and never really allowed me that opportunity. Cindy knew I was in dental school and knew how driven I was to succeed. I honestly felt I would let her down if I didn’t push myself through this.

In 1997, my life began to unravel. I was going through a painful divorce from a woman who was my best friend and high school sweetheart.

I was involved in a court case for custody of my four-year-old son, which lasted two-and-a-half years. It was the fight of my life. It is very difficult for a man, regardless of the circumstances, to receive full custody of a child, but nevertheless, after nearly three years in court, I was awarded full custody. Bill, the owner of ProDentec, was very instrumental in me keeping my sanity throughout this process and helped me in ways I can’t possibly measure. Without Bill’s phone conversations during those years, I shudder to think where I would be. I will never be able to repay Bill for all of his help during that time.

My son traveled with me to every seminar (Bill made arrangements for this to work) until I was forced to enroll him in school. I always joked that Alex, my son, was getting a more well-rounded education with me on the road than he was ever going to get in school. Calamari and mussels became dietary staples for a traveling four- and five-year-old. Alex and I raised each other for nearly four years. Then, in 2000, I met my soulmate, Tiffany, who was a hygienist. (I always swore I’d never marry one). Little did I know she was a regular attendee at meetings I provided in Indianapolis. Her doctor used to tell her, “Tripke’s in town. Wanna go?”

In 1998, I was giving a presentation in Indiana, and after the lunch break, I proceeded to start the afternoon session, in front of about 150 dentists, hygienists and staff. As I walked out into the audience, a voice kept talking to the point of being a distraction. It became so annoying that I looked to my right and said, “You’d better pay attention. We’re going to have a quiz.” As I said it, I noticed it was a conversation between a doctor and his hygienist. She kind of snarked at me as if I had embarrassed her. Long story short, I finished my presentation and returned home.

About two years later, I was in Memphis, Tennessee, to provide a seminar. It was about 4:00 p.m. on a Thursday, and I was getting ready to go out to dinner with the traveling representative from ProDentec. My cell phone rang in my room, and it was Doug, the person who normally traveled with me to a seminar location. Doug was in the office training outside sales representatives for the company. He told me he had met someone that day, a nice lady, and he thought I should give her a call; he thought we should meet. Well, me being me, I said, “How is that going to happen?.”

He said, “Just call her.”

I said, “Doug, you can get accused of sexual harassment by simply telling a lady that she looks nice in her dress. There’s no way I’m calling her.”

Well, I ended up calling her on a Monday night, just after I had put Alex to bed, about 8:00 p.m. We proceeded to talk until 10:00 p.m., and as I was about to hang up, I told her I needed to ask a question that was driving my curiosity crazy. I asked her if she had ever been called out by me at a seminar, and she said yes. She then told me that I had said “You’d better pay attention. We’re going to have a quiz.” At this point, I felt this relationship was probably now going nowhere! I proceeded to tell her what color her...