Don’t refer pediatric patients: One dentist’s secret for young patients
Successfully treating pediatric dental patients is a rewarding experience that calls for a certain sign of clinical competency and is a significant component of maintaining a highly successful practice. If kids like you, the entire family will follow, even Dad . . . eventually.
I practiced in a small town where referrals were anathema, as they meant at least a two-hour round trip drive and an entire day of wasted time and lost wages. So, from TMD, orthopedics, and orthodontics, to oral surgery, molar endo, and pediatric dentistry, I did it all. This versatility is one reason why for 40 years, in recession and prosperity, my schedule remained full. Yet many practitioners, even so-called “family dentists,” refer many youngsters to a pediatric specialist. I contend this is an unfortunate and uninformed choice that the following ideas will help remedy.
Also by John Wilde
How dentists can join the "Millioinaire's Club"
How dentistry can become a path to financial freedom
Our office created “happy visits”
Our profession encourages parents to bring children to the dentist soon after they turn one. I performed 1-year-old exams with the child reclining on the mother’s lap, where screaming afforded an excellent look at the child’s dentition. After this visual exam, the remainder of the appointment was a consultation when I discussed proper brushing, ideal toothpaste and amount, proper use of fluoride, and answered sundry questions.
We automatically appointed 2- and 3-year-olds for a “happy visit.” We scheduled this two-minute no-charge procedure with an assistant. (I’ve found that most practices are blessed to have at least one staff member who adores kids.) All five of our operatories had a seat available for parents. We always invited parents back with their child because what they might envision while sitting in the reception area is many times worse than anything we ever did.
We made the effort to get our Lilliputian patients to sit in our big chair “like a big girl or boy,” then gave them a “ride.” Mr. Slurpy noisily drank a cup of liquid, we blew air, water, and spray on the patient’s hands, and they got loud kisses from our HSE system. While they played with our disposable hand mirror, we encouraged them to find their teeth. We also asked them to tell us what they thought our pink elephant nose smelled like (our pediatric nasal hoods were all bubblegum scented) and asked them to place it on their nose like a spaceman or deep-sea diver.
I restored all primary teeth with N2O and no local anesthetic for decades, as did my five associates. No numb lips or “mosquitoes bites” was a big plus, and because the nitrous onset was one minute, we saved time. After completing thousands of successful appointments, it’s always a bit dumbfounding to me when a dentist who has never used nitrous blithely informs me that it’s impossible. (Remember, a parent is present during all treatment, and there is no incentive that could induce me to treat an uncomfortable patient of any age.)
We added some extra touches
To conclude the “happy visits,” the dentist they would see at their next appointment for a complete exam and x-rays dropped in to say hi and share a high-five. When the chairside fun was over, the child went to our treasure chest to pick out two toys for being extra good. We had a large container with an abundant variety of toys, so selection could take a while, and this interlude allowed us to answer the parents’ questions. We also dispensed a brush, toothpaste, and a generous supply of sugarless hard candy (which is delicious and stimulates salivary flow and can reduce decay, but few parents are aware of this).
To generate enthusiasm for the “real” exam, we had a no-cavity club, in which we entered all decay-free kids for a monthly drawing to win stuffed animals so large we suspended them from the ceiling of our reception area. The winner of this event was featured in the local newspaper in a photo with the stuffed animal and staff members. The names of every cavity-free kid who visited that month was also listed in the article, followed by a message explaining the importance of excellent oral health in children.
“Happy visits” were fun occasions, and parents who dreaded their precious child’s first dental visit were delighted by the outcome. If all went well, we scheduled the dentist's exam in about one week. However, if that visit went poorly, we arranged another “happy visit” within six months, thus avoiding a screaming kid, anxious parents, and stressed doctors.
As unrelenting fee pressure from insurance companies indicates, people often see dentists as fungible commodities, one as good as another. We know this is utterly false within the profession, and this piece of a multifarious mosaic—reaching pediatric patients—represents a way by which we can demonstrate distinctiveness. The unique and positive “happy visit” experience also strengthens trusting patient relationships that are the key to long-term success, thus advancing one’s passage toward excellence, even mastery.
