#21: The Build-Up Weekly

Author

Trevor Kimball
August 18, 2023

*Welcome to the 21st edition of The Build-Up, where we deliver weekly insights and inspiration for dentists on every stage of the private practice journey. If this email was forwarded to you, you can click here to subscribe.

Dear friends and colleagues,

What a week. The sun is shining (finally) after some odd, rainy weather.

And speaking of odd, apparently Elon Musk and Mark Zuckerberg are planning to face each other in an MMA fight at an ‘epic location’ in Rome. Wonders never cease. (I’ve included a video of another world-historical event at an epic location in Rome at the end of this email.)

This week I am in Alaska (I’m scheduling this ahead of time). I’m very excited to step away from the day-to-day whirlwind and take some time away to rest.

I would also like to congratulate Dr. Mike for winning our Southwest Airlines giveaway! I appreciate everyone who filled out that survey. Perhaps Dr. Mike will share how he uses the gift certificate in the coming months!

Here’s what I have lined up for this week’s newsletter:

  • The Secret Ingredient in Vienna Sausages

  • Presenting Perio to Patients

  • Other ‘Epic Locations’ in Rome

Let’s get started!

The Secret Ingredient in Vienna Sausages

This is a weird one, but summer is winding down and I’m sure there’s a lesson in here somewhere. This comes from a newsletter devoted to engineering, manufacturing, and infrastructure called Scope of Work, in an issue about secret ingredients.

If nothing else, it’s a great anecdote to take to a party or share with your family this weekend.

When Chicago’s Vienna Sausage Company moved from its original premises which were “put together in a Rube Goldberg kind of arrangement” to a brand new state-of-the-art facility, the sausages didn’t taste as good. For a year and a half, the company tried to work out the problem to no avail. One day, workers were reminiscing about an ex-employee, Irving, who didn’t come to work at the new factory due to the long commute required. Irving’s job was to move the sausages from the filling room to the smokehouse, taking them on a half hour journey through a maze of rooms where other products were getting produced. After noting this absence, it clicked that Irving’s daily trip was the secret ingredient – on his journey the sausages were getting pre-cooked and infused with flavor. The company was eventually able to recreate the sausages’ original taste, building a brand new room onto the factory which emulated the properties of Irving’s trip.

Scope of Work Newsletter

Tips for Presenting Perio Treatment to Patients

Is your hygiene team providing ideal perio care, or are they doing a lot of difficult prophies?

Over the years, we've seen too many hygienists working hard to complete a "challenging trophy," only to end up with carpal tunnel symptoms and patients with less-than-ideal periodontal health.

Many offices think that they are consistently diagnosing perio and that their treatment plans are being accepted by patients…but the proof is in the proverbial pudding.

If I were to look at your dental software and run a procedure report, what would I find? The math is pretty straightforward:

(This analysis works if your office is performing scaling and root planing and perio maintenance. If you refer 100% of your perio out (like the office we worked with that referred ANY patient with a 5mm pocket!), then this doesn’t apply.)

So ... run a procedure report and compare the amount of adult prophies to SRPs to perio maintenance.

If 33% of your patients are in a perio program, then you should see 50% of the adult visits as SRP or perio maintenance and 50% prophies because perio patients come in typically 4 times a year and prophy typically 2 times per year (33 x 4 = 66 x 2).

If your office does prophies on 50% of the adult patients then you are likely doing ideal perio.

If you do 90% prophies, then you are likely doing "difficult prophies" (an oxymoron) and you might be skimping on valid treatment to get your patients healthier.

The CDC suggests that 47% of US adults have some form of periodontal disease.

If that’s the case, and your patient population reflects the wider US, then more than half of your hygiene appointments should be with patients who are being seen 3 - 4 times per year.

So how do you present perio treatment more effectively?

Your hygienists are like nurse practitioners for the mouth. In my experience, they are passionate about the health of their patients and about educating them about the dangers of disease.

The first step is a process of co-discovery.

Have your hygienists call out the clinical standard and give context to the exam.

For example:

“In order to make sure your gums are nice and healthy, I’ll be doing a periodontal assessment of your pocket depths. 2-3mm is normal, 4 is borderline, and 5 could mean periodontal disease. Bleeding shows active disease and is not normal or healthy.”

Call out numbers aloud, call out bleeding.

When you’re finished probing, don’t just carry on with your exam. If there are deep pockets and lots of bleeding, sit the patient up and have a conversation with them.

Remember that our words are only part of the communication happening with your patients. When we sit the patient up and look them in the eyes, we add gravity to the situation. It lets them know that when we say we’re serious, we’re actually serious.

This is your chance for patient education and health advocacy!

Our hygienists have more time and interactions with your patients over the years, so they are in a great position to really see changes and patterns.

Honestly offer your patients everything that could benefit them. Don't hold back and tell them half-truths to keep them from being upset. We're talking about their total health, not just their gums!

If you’re consistent, not only will you have healthier patients - you’ll probably need to add hygiene days. 🙂 

Three Tenors Debut in Rome

July 7, 1990. The Terme di Caracalla in Rome. 6000 people in the live audience.

Over one billion watching at home.

The debut of the Three Tenors (Plácido Domingo, José Carreras, and Luciano Pavarotti) in Rome on that starlit evening in July was an instant classic.

The concert recording became the best selling classical music album of all time.

One billion people.

You’ve certainly heard Nessum Dorma from Puccini’s Turandot. But you may not be familiar with the opera’s insane plot. And if you ever get a chance, the first 10 minutes of this course on opera is worth the $13 subscription to Wonderium.

Enjoy!

And with that, I hope you enjoyed the 21st edition of The Build-Up Weekly.

Please consider using the link below to share our newsletter. 🙂 

With best wishes to you and your families,

Trevor Kimball, PhD

These Six Mistakes Can Cost You Six Figures

You can download it for free here. It’s material that I’ve covered in this newsletter before, but - if you’re contemplating a practice sale - the advice in this guide is crucial.

And if you’re ready to have a conversation with a practice sales professional, get connected with your local Integrity Practice Sales broker here.

It’s worth having a conversation no matter your current transition plans. You never know what you’ll discover together.