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From Our Archives - Dentistry in Difficult Economic Times

Dentistry in Difficult Economic Times

Dr Jon Kozeniauskas wrote this in 2008

We just came across it in our archives and thought how incredibly relevant this still is for dealing with the current economic crisis of 2020

Interest rates are going up, banks are failing, the US economy is in trouble, the stock markets are falling, pension funds have dropped, so what does this mean for our patients and consequently us?

Put this into the context of the GFC in 2008

- People are living on extremely tight budgets.

- Uncertainty of costs- patients do not know how expensive (or inexpensive) a visit to the dentist will be.

- This uncertainty leads to fear of the unknown which contributes to an already existing fear of making an appointment with the dentist.

Taking into account all the contributing factors above, we must consider why it is that places like Harvey Norman are full on the weekends with people buying plasmas and other unnecessary items when they do not have the expendable income? Their priority does not lie with their dental health.

2020 example could be Bunnings which is always busy & images of people buying loads of non essential items.

Making Dentistry a Priority For Your Patients


  • Patients do not understand the importance of oral health and are not seeing the value in dentistry.

  • All practices have very low return of patients for PC’s and when they are phoned to make the next PC appt, patients do not know why they should return unless they are in pain.



  • Explain to the patient at every New Patient or PC exam

  • Lifetime consequences of dental health on their general health – eg gum disease can increase the risk of heart disease, diabetes, obesity, lung disease

  • The effects of perio on patients’ health and well being

  • That good gum health = keeping your teeth for life

  • That decay can be controlled and should not be left untreated


  • Give patients info sheets to reinforce the dentist’s message

  • Note on the front of the patient card – the specific reason for them to return for their next PC appt – not just 6/12

Patient Communication At Every Appointment - The Dentist must -

  • Introduce him or herself and make sure your team introduces themselves – this is very important to make your patients feel calmer and important

  • Allocate time to communicate with every patient. At the end of the appointment sit the patient up, bring the dental chair around to face the patient and make eye contact. Explain their treatment plan ask what questions they have. Remember the key to communication is listening.

  • Be direct and specific in your explanations

  • Begin with small “bites” of required treatment – make it seem possible for the patient to afford the treatment that you are presenting and that they have options.

“How Do You Eat An Elephant? One Bite At A Time”

  • Don’t use complicated language (patients don’t know what perio, caries, endo mean)

  • Do multiple units in an hour appointment to get the average cost per unit of dentistry down – eg 1 hour appts or X 2 ½ hour appts and space the treatment out over time

  • Reduce the cost per unit and tell your patients that you have discounted the price for them – no one appreciates anything unless you tell them what you have done

  • Delay Crown and Bridge until you have established a relationship with your patient.

  • Remember that a crown or a build up is still working at $500 to $600 per hour - based on 2008 fees

  • When offering a range of treatment options and costs for each option consider using different labs when appropriate or reduce the cost of the procedure for your patient

The Importance of Perceptions

Perception is made up of:

1) Patients – and their community

2) Staff

3) Dentists


  • Unfortunately patients often have an irrational fear of the dentist and usually for no reason at all.

  • Their primary judgement of you comes down to their experience at the clinic and the expense they are going to incur.

The key to overcoming this is taking the time to develop:





People Before Teeth.

  • The Patient’s comfort and experience should be your and your teams priority for every patient every day – you need the patients to want to return

  • Demonstrate respect to the patient – never make derogatory comments to your team because this creates negativity that is just unnecessary

  • Communication is the key at all times – Take the Time

  • Understand your patients needs – by asking them – it is not about you the dentist and what type of treatment that you want to do – it is about providing quality dental options that best meet your patients needs, budget and desires

  • Inform patients of ALL treatment options and costs and let them be in control of the decision. Give them a quote. Patients’ must know exactly how much they will need to pay, no surprises. This way they can plan and budget accordingly. You may need to accommodate their needs by spacing out appointments where possible. Let them know you are there to help and assist wherever possible and are not just after their money.

  • Begin with the urgent dental health issues for each patient – such as gum health and decay before whitening and crowns.

  • Go slowly with your patients’ treatment plan

  • If you explain what is happening with each patients’ dental health and take the time with every patient – your patients perceive value

  • If you have no discussion or education or opportunity for the patient to make their own choices, then patients’ think you are ripping them off and will make sure they tell everyone they know


  • Is a significant factor in patients not returning or avoiding visiting

the dentist.

  • A dental visit is associated with huge expense.

  • Do multiple units of treatment in an hour appointment to get the average cost per unit down


  • Patients love a saving

  • Build Relationships with these new patients

  • Do not use the following patients as just ‘fodder’ – they can be Ongoing patients if you take the time

Medicare- Bulk Billing our service (this does not include Labs). With GP referral a patient can get $4,250 worth of dentistry done. No longer relevant in 2020

Teen Dental- $150 voucher- cover exam, scale and clean and two x-rays in this appointment No longer relevant in 2020

50% off PC- this is being offered to existing patients and local traders

Zoom – a great introduction to a potential new patient

Implant Evenings

- Offering discounts gives patients a sense of trust but a feeling that they are getting great value for money.

It is important that any discount you give be it one of the above or something else that the patient is aware of the saving they are making.

Tell them how much it should have been but how you have cut the price for them.

“Explain It All – Giving Value

No Discussion – It’s a Ripoff”

Your Relationship With Your Team

  • Understand that the way you communicate with and treat your team – reception, surgery assistants and dentists in your practice has a huge impact on your patients and how they perceive you.

  • This communication and professional approach to your team also ultimately impacts on your success in the practice and level of income achieved.

  • Your level of professionalism with you team – Sets the example for the behavior of your team members.

  • If you do not care – they will also not care

  • If you are ‘sloppy’ and have poor standards – then so will your team

  • If you leave your dirty dental gown ‘dumped’ in the tea room or change room – then that is what your team will also do

  • If you do not professionally present yourself and pay attention to your image – then your team also takes short cuts and look disheveled

  • If you wear a dirty dental gown every day – what does this say to your team? – what standards of infection control and quality care are you offering – you are seen negatively by your team and patients

If you:

Criticize your team

- They do not promote you to patients

- They do not give you their full support

- They fill the dentists that treat them with respect first

- Patients perceive that you are not a very trustworthy person if they hear you ‘putting your team down’


- Be clear and realistic about your expectations of your team

- Take the time to outline your specific needs and wants with your team

- Look for the positives in each team member – they are actually trying to please and support you

- Give constructive feedback and not criticism

- Say Thank You

- Do not lose your temper

If things are not going well for any reason

- Put the patient first

- Take control of the situation

- Stay calm at all times

- The patient and the team must see that you are in control of yourself and the situation

- Once the emotion has passed – only then sit calmly with your team and explain how things could and need to be done differently in the future

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