Case Study Presentation

Consultant: Hello, what seems to be the issue with your teeth?

Patient: Hi, well, I’ve had this tooth problem for over a decade now. Whenever I eat, food gets stuck, and no matter how much I try to clean it with a toothpick, it doesn’t help. It’s really uncomfortable.

Consultant: Oh, for how long has this been happening?

Patient: I’d say it’s been over ten years now.

Consultant: Ten years, and it’s been bothering you all this time?

Patient: Yes, that’s right.

Consultant: I heard from the doctor that you came from the orthodontic department, is that correct?

Patient: Yes, that’s correct.

Consultant: Can you lie down for a moment? I’ll take a look to see which tooth is causing the problem.

Patient: Sure, no problem.

Consultant: Those two molars at the back, you know? The ones with the gap in between? That’s where food tends to get stuck, causing discomfort.

Patient: Sorry, I need to take this call.

Hello? Yes, Mr. Zhang. Yes, I understand. I’ll be there shortly. Okay, thank you.

Consultant: So, about your tooth issue, it’s often getting food stuck. What could be the reason? It might be due to the gap between your teeth and some gum inflammation. Have you noticed any bleeding gums in your daily life before? It seems like you’ve had such situations in the past.

Patient: Yes, but it wasn’t severe. Sometimes there was bleeding, but it’s all fine now. I don’t experience that anymore.

Consultant: Right, when you had bleeding gums, you probably didn’t pay much attention, right? Sometimes, when you bite into an apple, there could be blood marks, and occasionally bleeding. However, it seems to have improved now.

You seem quite busy. Oh, my phone keeps ringing. Could you spare a moment to listen to me?

Patient: Yes, sure.

Consultant: You might be a bit busy, but let me explain about your tooth. You might not have paid much attention before, but due to long-term smoking and drinking, your gums often bled. Now, it has developed into tartar, which is hardened plaque. It’s difficult to brush away, causing your teeth to feel sparse. The best course of action would be to remove the tartar and undergo a systematic periodontal treatment.

Patient: Sorry, I need to take this call.

Hello? Okay, I’ll be there shortly.

Consultant: You’re quite busy. Alright, go ahead.

Case Analysis

Hello everyone,

I just reviewed a case that many doctors in our clinical setting find challenging. Firstly, the conversion rate of referred cases isn’t as high as we’d like, and secondly, we receive a significant number of phone inquiries. So, in such circumstances, what can we do differently? Even if we can’t retain the patient today, we can at least lay the groundwork. Or, in simpler terms, address the immediate issue while keeping the possibility of their return open. Why? Because our orthodontic relatives play a significant role in this patient loss. Allow me to analyze this scenario from six different angles.

Firstly, the orthodontic referral process often lacks adequate groundwork. Before the referral, could our doctors inquire about the patient’s needs? For instance, do they experience any other symptoms besides misalignment? Do they feel any discomfort? Effective communication is crucial here.

Secondly, do we introduce the unique features of our periodontal department and the specialties of our doctors before the referral? It’s essential to present this information appropriately.

The third point is about leading the patient to the periodontal department before referral. So, before this, have we had sufficient communication with the receiving doctor or periodontist? Therefore, before referral, we must lay the groundwork, just as we must prepare the patient before tooth extraction. Otherwise, if he comes today just to solve the problem of tooth impaction and then immediately faces extraction, he will find it difficult to accept. So, the customer describes the problem as tooth impaction, especially when eating. It’s just inconvenient. He always feels impaction but doesn’t realize the potential hazards it poses. This is something he is not aware of, but at this point, the doctor needs to explain it thoroughly. At the time of examination, your reception and examination should not be too casual. If it’s too casual and lacks strategy, coupled with being quite busy and receiving many calls, the doctor is always passive, making it difficult for the customer to respect the doctor. At this time, we need to adopt some strategic measures to create conditions as much as possible to make him cooperate with our examination. So, during the examination, our endoscope, such a good communication tool, is not being utilized to its full potential, and before accepting periodontal disease treatment, it is necessary to first arrange for an X-ray or CBCT scan. So, if he agrees to take an X-ray or CBCT scan, the success rate of periodontal disease treatment can reach at least 50% or more. Through the endoscope and X-ray, the results obtained can facilitate further communication. Firstly, it’s more intuitive, making it easier for him to understand, coupled with our written and illustrated explanations. The purpose is to create resonance. For example, symptoms. Apart from the impaction, is there any odor or any foul smell trapped inside? Secondly, are the gums red and swollen? And whether there is bone resorption around the seventh tooth. All these can be shown to him, as well as the bone resorption shown in the X-ray. Then we explain the reasons for tooth impaction. Due to improper extraction or gaps, and the thickness of this area makes it difficult to brush thoroughly. On the other hand, due to this phenomenon, what kind of impact does tooth impaction currently have? And if it continues to develop further, what kind of hazards will it pose? After explaining this, we must make him resonate, and he will realize that this kind of development could be very troublesome. It might affect the front teeth. He may only feel tooth impaction but doesn’t realize the potential impact or hazard. Also, for example, where does bad breath come from? It might be greatly related to this. Then we explain where bad breath comes from. On the one hand, it comes from the whole body system, such as our digestive system, which is quite rare. And there may also be systemic diseases, such as, for example, diabetes patients. Then, from his breath, we can judge that he may have diabetes. Another local factor is what? It’s the tartar and food impaction under the gums, which ferment and cause another condition, such as tongue coating. So, the main reason for this situation is the impaction, which causes many problems. If tooth impaction is combined with bad breath, periodontal disease, and other factors, it will develop into a more serious problem, which will stimulate him to quickly want to eliminate this disease, the desire for rapid treatment. When the doctor designs the plan, he is under pressure, and whether to lead the customer to consume more. When designing the plan for customers with symptoms that are not very obvious and have a lower breaking point, you must have a comprehensive and selective approach. Genuine communication, patient guidance, but not deliberate sales. Especially for high-priced plans. So, for example, if the groundwork is done well, I will then design a plan. If the groundwork is not done well, I will definitely not mention the plan, let alone the price. So, the first plan is tooth extraction. Before tooth extraction, I recommend that he take an X-ray first. Sometimes he may find it difficult to accept, but in my style, taking pictures may be delayed, but there are sufficient reasons for taking pictures. So, the first plan is tooth extraction. Before tooth extraction, I recommend taking X-rays, and there are sufficient reasons for taking X-rays. Whether to extract without taking X-rays? It’s possible, but there are hidden safety risks. The second plan, such as periodontal treatment combined with tooth extraction. The third plan is to do periodontal treatment after tooth extraction. These two plans, sometimes I will tell him, if you agree to accept periodontal disease treatment, it is better to do periodontal treatment first and then extract the tooth. Why? Because controlling inflammation and avoiding gap infection. If you are unwilling to accept periodontal disease treatment, this tooth also needs to be extracted, and you can extract it first and then do periodontal treatment. But if you decide to do periodontal treatment, it is better to do treatment first and then extract the tooth. This is the third plan. The fourth plan is a conservative plan. This kind of plan is difficult for customers to refuse. For example, first, local anti-inflammatory treatment, then local conditioning, and then observe to see if the inflammation can be controlled. If not, we will further treat it. It can also be done like this. What can be left behind first? As long as it is retained, we can provide good service and have the opportunity to establish sufficient trust. Based on trust, and then further guide and promote, I believe we will achieve the desired results.

The fourth approach is a conservative one, which is challenging for customers to refuse. For example, we can start with local anti-inflammatory treatment followed by local harmonization and observation. By controlling inflammation initially, we can offer temporary relief and create an opportunity to further address the issue later. This approach allows us to retain the patient while building trust through our services. With trust established, we can guide and elevate the patient’s experience, ultimately achieving our desired outcomes.

The fifth aspect is that our service work is not up to par. For customers like this, who frequently make phone calls, I think in a sense, it’s disrespectful to the doctor. Why is it disrespectful? It’s because the doctor doesn’t respect the patient. This will lead to the other party not respecting the doctor. For example, if you are too casual when receiving customers and the customer just wants to solve tooth impaction, but then you mention extraction, surgery, and periodontal treatment, it’s all very troublesome. In situations like this, we need to improve our service, such as paying attention to details during examinations. For example, after the examination, I always request the nurse to provide good service. For instance, after the examination, I must rinse with a triple syringe, then spit out the water. At this time, the nurse standing nearby should take the initiative to hold a cup, not letting the customer handle it themselves. Personally bring it to his mouth, not letting him do anything, just move his mouth. After rinsing, pick up a tissue and help him wipe his mouth. It’s all about these details. If a very attractive nurse provides such services to a gentleman and it’s free, he will feel embarrassed. On this basis, if you still want to answer the phone, for example, the nurse can say, “Hello, sir, can we let the doctor finish explaining to you first, and then I’ll answer your call in a moment, or can I take the call for you first?” Or the doctor can indirectly say, “If the call isn’t urgent, could you hold for a moment? Let me finish explaining to you, it’s okay, I believe it won’t affect anything. I think your teeth are also very important, which is causing trouble today…” and have a sincere conversation with him. In short, find ways to turn passivity into initiative. Otherwise, the doctor will always be passive. So, in life, we will always be passive, and it’s difficult for us to take the initiative. Regarding this point, to make the doctor respect us, we must first respect the customer. This is a prerequisite. The sixth point is customer loss. When customers are lost, we fail to take proactive retention measures. For example, I see you have many phone calls today, and you are indeed busy. In this case, taking up a minute of time, I’ll first help you rinse the periodontal area for free, clear out the food debris, rinse the periodontal area, and then apply some medication to reduce inflammation and relieve symptoms. When you have some free time in the future, you can come back for a thorough treatment. Generally, it’s difficult to resist this approach because it’s free, and we need to pay attention to our manners and details. So, at this time, we sincerely help him solve the problem, not trying to make him spend more. Once he stays, lying in the chair, we must be gentle and meticulous during the operation, and he will feel that you are very attentive and not charging him. At this time, while rinsing and communicating, we conduct health education. The purpose of health education is to increase his awareness of the importance of teeth. If he values his teeth, he will prioritize dental appointments, and even money won’t be a problem. At this time, we don’t charge him for the medication, and for some old customers, if he is a family member of an orthodontist, after collaborating with the orthodontic doctor, we can actively give him a bottle of mouthwash. Firstly, I’ll help you handle it for free, then I’ll give you a bottle of mouthwash, and personally see you off. Secondly, seeing him off at this time will make the customer feel that our service is exceptional, experiencing our service and recognizing its value. He will feel apologetic and understand that we will call to check on him next time. Checking on him is not about extracting teeth or doing periodontal treatment, but about whether his symptoms have improved recently. If not, he can come back for further treatment.

Lastly, it’s crucial to adopt a patient-centric mindset and prioritize their needs and concerns. Understanding patients’ perspectives and addressing their immediate concerns fosters trust and cooperation. By empathetically addressing their needs and offering tailored solutions, we can significantly improve patient acceptance and retention rates. Moreover, maintaining open communication and genuine care for patients’ well-being can further strengthen their trust in our services.

In conclusion, by implementing these strategies, we can effectively address patient loss and improve retention rates in our practice. Thank you for your attention.