Endodontic Resources to Make You Better Tomorrow!
… Successful negotiation to patency.
Listen here to my introduction to successful negotiation to patency:
The entire audio lesson is in our Free Library. Sign up! If you are already a Free Library member, listen to the full audio lesson here: Free Library Audio Page with Successful Negotiation to Patency
Happy Endo My Friends,
Reid
P.S. We’ll cover in detail negotiation to patency and many other important topics in our April 13-14 Root Camp, Boot Camp. Sign up now!
Greetings Clinicians,
In over 18 years of practice, I have learned and developed some of the most effective patient one-liners to explain root canal treatment, success/failure, etc. These one-liners convey meaning and understanding to the patient in one quick and simple statement and end of saving me a lot of time. I would like to share 3 of my favorite one-liners that just seem to WORK. Patients rarely ask for more clarification after these statements.
There is a periodical radiolucency lesion present and the patient is asymptomatic and is unsure if they want to have a root canal. This is what I say, “You have a bone infection and we need to clean out the infection inside the tooth to to get healing of the bone.” Patients hate the term bone infection and equate it with bone cancer or an infection that may spread to the brain. This one-liner usually motivates the patient to have same-day treatment.
Patient has cold pain and the Dx is Irreversible pulpits (IP)/Symptomatic apical periodontitis. How do you explain that they need a root canal? I say with extreme confidence, “You need a root canal.” Revolutionary I know! Saying it with confidence just after testing the tooth or teeth and causing pain is usually all you need. Here is a follow up just in case it is needed (the sprained ankle analogy): “When you sprain your ankle the tissue at the ankle swells. It is the same inside the tooth. There is inflammation and swelling inside your tooth causing pain.”
I say this when I see a failed root canal- “Sometimes root canals come unsealed.” (I learned this from Ace Goerig and it is a great way to explain a failed root canal by another dentist or you without placing blame). I blamed myself for 15 years on anything that went wrong in dentistry and now have been shifting the blame to the tooth (unless I did something than I take ownership).
We have just added Newsletter #4 to our Resident Library, and it contains 32 productive patient management one liners, grouped by treatment category.
Happy Endo My Friends,
Reid
(The story of my witch patient)
In a perfect world we would finish all of our root canals in one visit, prep the tooth, and cement the crown an hour later. It would be seamless and effortless and everything would succeed. Unfortunately, life is not ideal and endodontics is not perfect, patients can be a pain in the rear, and sometimes it takes two visits to finish root canal treatment.
So how do we manage patient expectations prior to the start of the root canal process? How do we communicate the reason why we are needing two visits to complete the endo? How do we make sure the patient comes back for completion and does not get lost in the sauce?
In the Army, I performed root canal treatment on a real live WITCH. She was a wife of an American soldier who happened to be a Wicca leader for the military in Germany. She came in one day on an emergency basis in a great deal of pain. I performed a pulpectomy (cleaned out the majority of the nerve to the apex at least up to a #25 hand file- ideal pulpectomy) and placed calcium hydroxide. I informed her that she needs to come back so we can complete the root canal treatment and restoration. I then promptly forgot about her except the witch part.
One year later she comes back to the clinic swollen and in pain. I look back in the records and see that she never came back for the completion of the root canal treatment or restoration and that we never called to re-appoint. Now I’m nervous because she’s a witch and what if she puts a spell on me (she told me she is a good witch and only practices white magic and doesn’t really place spells on people- Yes I asked her!)?
Again I perform a pulpectomy and place new calcium hydroxide and place her on antibiotics (I routinely give Amoxicillin 500mg, 1 g loading dose and then Tid for one week or for serious infections or an allergy to Penicillin, Clindamycin 300mg, 600mg loading dose, Tid for one week). This time she comes back in a week and I complete root canal treatment and the restoration and it was a success because I exited the Army 8 months later (geographic success!).
I have learned a lot since the early days and now I have communication procedures for everything I do in my practice. My goal is to manage patient expectations right out of the gate. Fist off, I tell my patients that, “This root canal will take an hour to an hour and a half and it may take 2 visits”. I have said this phrase ~8000 times and it works. If it takes two visits, I tell them, “We had to place an antibacterial medicine inside the tooth to help kill the infection.” If its vital (Irreversible pulpitis) then I say, “We had to place an antibacterial medicine inside the tooth to help kill the bacteria (because the tooth is not infected)”. I have said this ~3000 times and patients accept it for the most part because you are placing medicine to help kill the infection and in their mind prevent it from spreading.
The last step is to have good recall and re-appoint systems so that the patient does not get “lost in the sauce.” Make sure your front office appoints the patient for the completion appointment prior to them leaving and call and remind them of their next appointment.
I hope this helps. Please visit RootCanalAcademy.com for more patient one-liners.
Happy Endo My Friends,
Reid
Dear Clinician,
Root Canal Academy is launching a new content series on ‘Patient Communications,’ which is a response to the numerous questions that I am getting about the topic directly, or questions that point to the effectiveness of patient communications. It is clear that the topic warrants a special series.
Managing patient expectations prior to starting the root canal treatment is vital to preventing miscommunication and possibly angry patients. Patient expectations are formed by HOW YOU SAY WHAT YOU SAY. When you link your treatment procedures with your communications, and state your recommendations confidently, patients are inclined to feel satisfied. Happy patients tend to be much more enjoyable and they also pay.
I hope you enjoy this first discussion about ‘how you communicate,’ and see how it can greatly influence the success of your treatment.
Please ask any questions or give me comments,
Reid
ReidPullen@RootCanalAcademy.com
Dear Clinician,
The 2 Day Root Camp Boot Camp will make you a better clinician and help you finally learn a root canal system or playbook. The 4 Quarters of the Root Canal Game playbook will give you a step-by-step method and will help you avoid feeling lost inside a tooth during your next root canal. Come and learn with me and be ready to dominate your next root canal.
Reid
