Designing Healthy Smiles: Evaluate, Communicate, Formulate

Transcription

1 Designing Healthy Smiles: Evaluate, Communicate, Formulate Samantha Meltzer-Wendell, RDH, MDH Manager Professional Education-Midwest Notes: Trends in Dentistry: Botox Interdisciplinary care Patients want an experience Services through mobile dentistry Social media/online reach Cosmetic dental simulation PATIENT FOCUSED TRENDS: Spa Dentistry Relaxation Room Aromatherapy Custom Rooms Herbal Neck Wraps Hot Face Towels Healthy Beverages TV/DVD s Soothing Music Soft Lighting American Academy of Cosmetic Dentistry Dental Trends: projected-2017-marketing-trends-for-your-dentalpractice Botox: dentists-botox-time/ Cosmetic Dental Simulation: CBCT: Orthodontics: Haywood, Van B. "Orthodontic caries control and bleaching." Inside Dentistry 6.4 (2010): American Association of Orthodontists Botox TMD Bruxism Facial Pain Cosmetic Cosmetic Dental Simulation Ability to see potential results before treatment Motivate patient to begin treatment Cone-Beam Computed Tomography 3 dimensional image Great tool for treatment planning and diagnosis Minimal radiation Orthodontics 58% increase in adults My Life. My Smile. My Orthodontist Average treatment duration: 22 months Average cost of treatment: $5,000 to $6,500 10% CP whitening gel Increase oral ph Kills cariogenic bacteria Reduce white spot lesions

2 Imako Cosmetic Teeth Secure Smile Snap on Smile Activated Charcoal Whitening: Oil Pulling: Halitosis: 1.Soares, L. G., and E. M. B. Tinoco. "Prevalence and related parameters of halitosis in general population and periodontal patients." OA Dent 2 (2014): J Nat Sci Biol Med Jan-Jun; 4(1): breathrx.php Dental Implants: *see resource page at end of handout Instant Hollywood Smiles Imako Cosmetic Teeth Available in 2 sizes Approximately $40.00 No dental appointment necessary Secure Smile One size fits all Approximately $48.00/arch No dental appointment necessary Snap on Smile Requires two dental appointments Made from dental resin Alternative Oral Hygiene Activated Charcoal for teeth whitening Very abrasive Staining, subgingival particles No evidence, not FDA approved Oil Pulling Ancient remedy Coconut oil commonly used Claim=eliminate bacteria/whiten teeth-no evidence Halitosis Affects 50% of adults in the morning 90% oral cavity 10% systemic Philips BreathRx system eliminates 99% of oral malodor bacteria Tongue Care+ combines Sonicare technology with BreathRx chemistry Dental Implants Bone friendly Improves facial structure Prevents teeth shifting Better treatment option Silver Diamine Fluoride Antimicrobial, desensitizer liquid Off-Label use by US Dentists for caries arrest and prevention Pros: Low cost, no drill Cons: Black stains, Irritates soft tissue, silver allergy Oral-Systemic Interdisciplinary care Educate medical profession DP s Research Silver Diamine Fluoride: * see resource page at end of handout 1st Call to Action: Identify/Use Viable Trends 2

3 3 Steps for Successful Whitening: 1. Know the difference between HP and CP 2. Identify etiology of stain 3. Select best whitening option for the patient s needs/wants Patient Barriers Time Money Don t See Need Lack of Knowledge Physical Limitations No Pain No Problem Fear Life Gets in the Way Past Negative Experience Co-Diagnosis Approach Patient owns their disease Involve Patient as Part of Exam Intraoral Camera Hand Mirror Professional Barriers Hinder patients success Pre-Judgments Miscommunication Perceptions Effective Communication Interpreting patient wants Body Language Education WHITENING: Kiosk Whitening Franchise 15 minute procedure Unregulated Non dental professionals Whitening Hydrogen Peroxide (HP) Active min 50% released 1st 30 minutes Carbamide Peroxide (CP) Active 2-8 hours 50% released in 2 hours CP breaks down to HP and urea Teeth are semi-permeable membrane Color change occurs when peroxide 2nd Call to Action: Enhance communication skills 3

4 Notes: During the Shade Assessment, use the verbiage: In addition to your cleaning, Dr. has asked me to establish your baseline shade. We know as clinicians, teeth darken with age. So I will assess your shade for your chart. Diagnose Etiology of Stain Yellow Brown White Grey Tetracycline Tetracycline Stains What are the best treatment options? Shade Assessment BEFORE Whitening AFTER Whitening POST 2 Weeks Set your Vita shade guide up in the following fashion: Arranged from the lightest to darkest shades, the progression is: B1 A1 B2 D2 A2 C1 C2 D4 A3 D3 B3 A3.5 B4 C3 A4 C Have the patient agree on the number, 1 through 16. A3 means very little to a patient, A actually sounds good Document the shade in the chart. *remember that everyone has a whitening end point which can vary between patients *manage your patient s whitening expectations, do not make shade promises-everyone whitens differently 4

5 Whitening Best Options: Ask Patients What They Prefer? Notes: Haywood VB, Berry TG. Natural tooth bleaching. In: Summit JB, Robbins JW, Schwartz RS, eds. Fundamentals of Operative Dentistry: A Contemporary Approach. 2nd ed. Chicago: Quintessence Publishing Company, 2001; Whitening Options In Office Light activated Non light activate Whitening varnish Take Home Custom trays Non-custom trays Over the Counter: Strips Pens In-Office Whitening Chairside Application 25-40% Hydrogen Peroxide Minutes Benefits for the Patient Faster whitening results No hassle with take home trays Applied by a dental professional Take Home Whitening McCaslin AJ, Haywood VB, Potter BJ, Dickenson GL, Russell CM. Assessing dentin color changes from night guard vital bleaching: Journal of the American Dental Association 1999: 130: Joiner A. The Bleaching of teeth: a review of the literature. Journal of Dentistry 2006; 34: Albers H. Lightening natural teeth. ADEPT Report. 1991;2(1):1-24. Philips Zoom DayWhite 6% HP minutes daily 9.5% HP minutes daily 14% HP 30 minutes daily Philips Zoom NiteWhite 10% CP 2-4 hours daily or overnight 16% CP 2-4 hours daily or overnight 22% CP 2-4 hours daily or overnight Haywood VB, Heymann HO. Nightguard vital bleaching. Quintessence Int. 1989; 20: In: Howe-Grant M, editor. Encyclopedia of chemical technology, 4 th ed, vol 4. New York: John Wiley and Sons: 1992 p Over the Counter Whitening Products Over a billion dollars spent annually Vary in concentrations Different delivery methods Common Disadvantages of OTC Products Patients lack access to sensitivity protocol Results take extended periods of time due to low concentrations May take multiple purchases to achieve results can become costly Patients may simply be whitening their disease 5

6 P. Charakom,et al. The effect of preoperative ibuprofen on tooth sensitivity caused by inoffice bleaching. Operative Dentistry Mar-Apr Watts A, Addy M. Tooth Discolouration and staining; a review of the literature. British Dental Journal 2001; 190: Wattanapayungkul P, Matis BA, Cochran MA, Moore BK. A clinical study of the effect of pellicle on the degradation of 10% Carbamide perioxide within the first hour. Quintessence International 1999; 30: Gillam DG, Aris A, Bulman JS, Newman HN, Ley F. Dentin hypersensitivity in subjects recruited for clinical trials: clinical evaluation, prevalence and intra-oral distribution. J Oral Rehabil. 2002;29: Making It Easy for Patients to Say Yes by Dr. Paul Homoly, CSP Amorphous Calcium Phosphate Relief ACP Oral Care Gel is the only FDA-cleared, dual-action formula created to comprehensively treat patients suffering from tooth sensitivity. Sensitivity Protocol Toothpaste containing potassium nitrate 2x daily for days prior 1 hour prior: 600mg ibuprofen min prior: Wear Relief ACP in take home trays Post Whitening Instruct patient to avoid chromogenic foods and beverages two hours following in-office whitening, and thirty minutes following take home whitening Foods and liquids such as blueberries, blackberries, red wine, coffee, tea & tobacco contribute to staining Allow two weeks following whitening treatment to ensure the stability of color and bonding adhesion Definition of NO 10% Truly Don t Want It 3rd Call to Action Complete a shade assessment on every patient and integrate whitening when appropriate 90% Not in a Position to Decide Today 6

7 Practice Building Strategies: Philips Whitening Success Guide Best Whitening Practices Treatment Marketing Guidance to: Increase Satisfaction Attract New Patients Help with Product Usage Website Newsletter: Esthetic procedure of the month Patient testimonials Feature practice volunteering or community event Before/After photos also can be displayed in digital frame or tablet in reception area Treatment Completion Gifts Professional photo Charitable donation in honor of patient Gift card to restaurant or shopping mall Whitening touch-up kit Flowers Social Media Facebook Twitter YouTube Google Last Call to Action: Implement marketing strategies and partner with Philips Oral Healthcare! 7