Patient education - Teaching tools
7 Things Your Teeth Say About Your Health Thursday, November 25th, 2010 When was the last time you visited the dentist? Are your teeth in impeccable condition? According to a story on Care.com, some messages coming out of your mouth bypass the vocal chords. Turns out that your teeth, gums, and surrounding tissues also have plenty to say about your overall health. This just means, dental problems aside, bad teeth could signal problems your body is facing. Your mouth is connected to the rest of your body, says Anthony Iacopino, dean of the University of Manitoba Faculty of Dentistry and a spokesperson for the American Dental Association. What we see in the mouth can have a significant effect on other organ systems and processes in the body. And the reverse is also true: Things that are going on systemically in the body can manifest in the mouth. Read more .....Mom's kiss can spread cavities to baby
Patient education: Teaching tools
Brochures and flyers remain GPs' most common vehicle for
patient education. But multimedia, interactive programs also are helping you
educate patients and improve case acceptance. This exclusive DPR Survey Report
looks at how the dental team is keeping patients informed. - By Stan Goff
You can show patients a model, hand them a brochure, mail them a flyer, or have them view an interactive DVD program with a staff member. You can send them home with a DVD or ask them to visit your Web site to learn more about their treatment options. Storybooks with dental themes and children's activity sheets are popular with young patients.
But whether you're using all or some of the above-mentioned methods, you know by now just how important it is to have a well-educated patient. How can a patient make a decision–one that may be quite expensive–without knowing the benefits of treatment, and sometimes even more importantly, the consequences of non-treatment? Educated patients can lead to better treatment acceptance, higher comfort levels, and improved compliance.
During DPR's recent Webinar on digital radiography, Dr. Gordon Christensen explained the diagnostic and time-saving benefits of the technology, but also emphasized how great digital radiography is when it comes to patient education. Long a believer in the importance of patient education, Christensen's Practical Clinical Courses recently released a new DVD on patient education featuring 14 popular clinical topics.
Not every practice has a monitor in the reception area; not every operatory is computerized. But our 2006 DPR Survey (see "About this DPR survey"in related links below) on Patient Education indicates that on average, dentists say they spend 14% of their chair time involved in some form of patient education.
The results of your instruction efforts may not always lead to case acceptance. But at the very least, they should always leave the patient completely informed on treatment options as well as the consequences of not going through with the suggested care.
"I really don't think the dentist's job is to sell anything," said Virginia general dentist Dr. Timothy Hughes, who uses the CAESY Education Systems' programs in his practice. "Our job is to educate. You know, a picture's worth a thousand words, and a video is worth more than a picture."
What are you using?
Even most doctors who've invested in DVD interactive patient education programs to be viewed in the reception room and/or chairside or in a consultation room admit to using other methods to reinforce their messages. Sometimes it's just printing brochures from the programs themselves. CAESY, Consult-Pro dental patient education software, and other available services allow users to create customized materials to send home with the patients.
According to the survey (see "What are you using?" chart, below), the most popular form of patient education used is pamphlets/brochures for patients. Pamphlets/brochures for parents came next at 62%, with life-size or over-size models of dentition, gingiva or restorations the next most popular at 58%. Also used by at least four out of 10 of our readers are the following patient education media: flyers (50%), intraoral camera "tours" of the patient's mouth (48%), life-size or over-size instructional models of toothbrushes and floss (46%), before & after photo albums of patients treated in the practice (46%), and children's story books with dental themes (41%).
Almost one-third of the respondents use a practice Web site to educate patients, and similar percentages of GPs indicate the use of posters, magazines, and/or before-and-after stock photo albums. One-fourth (25%) of you are using DVD interactive programs.
"We also use some visuals, some handheld materials, and I'm ordering some implant models," said Dr. Leah Patrick of Dickson, Tenn. "But CAESY is nice, particularly for explaining conditions like TMJ-type symptoms and other topics that required a lot of detailed explanations."
Fans of interactive programs state that the clear, consistent presentations make all the difference in the world. No longer do doctors have to try and draw pictures to explain a root canal or other procedure, and no longer do various staff members need to try and remember every detail when explaining a case to a patient. Instead of getting different variations of explanations from various team members, patients can get the same clear message from one well-done presentation.
Dr. Patrick does not show videos in the waiting room and prefers music to information when patients are on hold. (See sidebar "On-hold messaging" in related links below). "I'm never one to push something on patients even though I do want them to be informed," said Dr. Patrick, who also uses intraoral and digital cameras for education and case presentation.
It should come as no surprise that the most popular responses we received when we asked about the topics covered in brochures, mailings, and statement stuffers were things like perio prevention, tooth whitening, brushing, and implants. These hot topics also regularly come up among those who use DVDs and other high-tech presentations.
When we asked specifically about mailings and handouts, however, the top response of 76% went to the prevention of periodontitis (see "Patient education topics" chart below). Bleaching was next at 70%, while two-thirds of the GPs indicated brushing, implants, and caries prevention as hot topics. Veneers (63%), crowns & bridges (62%), and sealants (57%) are also topics that the majority of our readers are addressing when educating their patients.
The array of ever-changing products, techniques, and clinical studies out there only reinforce the need for quality, up-to-date patient education. Manufacturers are constantly publishing new brochures and updating their Web sites, and those clinicians who do use flyers and brochures are most likely to obtain these from either the manufacturer or from a professional association such as the ADA (see "Where do you get your…" chart, below). Close to half of you (46%) prepare these materials in your own practice, which is yet another indication that more and more practices are taking advantage of technology to produce customized, effective publications themselves.
Those using multimedia presentations pretty much cover the same hot topics, and depending on their programs, can either send patients home with a personalized CD and/or customized brochures to reinforce the message delivered with the movies viewed in the practice.
"We use the children brushing technique video with virtually every kid," said Dr. Hughes. "Other common ones include perio, implants, and endodontics. A lot of people don't know what a root canal is. The graphics on CAESY are just excellent. In a minute they understand what would take me five minutes to draw and explain.
"The other one we like to use is the TMD module, because it shows the anatomy of the jaw joint. That's complex and hard to explain [without videos]."
Again, it's important to keep these presentations current.
That's why Toronto dentist Dr. Boris Pulec, who founded Consult-Pro (www.consult-pro.com), said his company is constantly updating its vast array of programs. Consult-Pro develops dental patient education software featuring multimedia presentations with 3D animations, still images and clinical photos.
"Root canals, fillings, basic dentistry are some of the more popular ones," Dr. Pulec said. "We'll show one on a filling, for example, and explain that if you don't fill, you may consequently need a root canal, then an infection, then a crown, then tooth loss, and so on. The program explains why options are suggested and the consequences of rejecting them."
"The program's networkable," added Dr. Pulec, who has six full-time animators who help update the movies on a regular basis. "You can put on a loop so you can play it in the operatory or you can play it in the waiting room, and you can pick your own presentations. You can put in your own slides and video, so it's totally customizable."
Currently, Consult-Pro offers presentations without voice, as Dr. Pulec said the videos explain the procedures clear enough to sell in 22 different countries without the need to translate, and are designed to have a member of the dental staff sit alongside the patient to answer any questions or concerns.
"This is made to motivate the patient and you can't motivate a patient by having them watch a video (by themselves)," he said. "You need to sit there with them so you can forward, reverse, skip, or slow depending on the patient's understanding."
Dr. Pulec said the program, which includes close to 600 different movies, offers a variety of topics and presentations that can help specialists as well as GPs.
"It's motivational not just educational," he said. "It shows the benefits of treatment and the consequences of non-treatment.
Where and what to watch?
Not every practice has a monitor in the reception area, but the majority of those who do take advantage of the opportunity to use it for patient education.
Thirty-eight percent of our readers have a monitor in the reception area and of those, 61% use it to show patient education videos
"Sometimes in the waiting room if there are kids there we run the kids' segments, which are really good for keeping kids occupied," Dr. Hughes said. "Other times we just run it on a loop that shows attractive smiles and before-and-afters that scroll by without any sound. I don't want to bombard patients with marketing while they're waiting."
He said that while most of the videos are not viewed in the doctor's operatory, sometimes that is the right place for the extra education. "It's done mostly in the hygiene rooms. In the treatment rooms, if a patient's waiting to get numb and has some questions, the chairside assistants use it too," he said of the CAESY programs. "I encourage the staff to use it often. I feel like we don't use it enough, like a lot of technology."
Dentists themselves are actively involved in patient education (see "Who's involved in the teaching?" chart below), with 95% of the survey respondents indicating such. But the survey also shows that hygienists and assistants also play a very big role in the teaching—84% in each case—and that 40% of the practices have the business staff playing regular roles in patient education
Dr. Dale Steiner, who remodeled his Chandler, Ariz., practice in January to include computers in the operatory, digital radiography, and CAESY among other upgrades, runs the patient education in his waiting room constantly.
"We have a big-screen TV and whenever we are seeing patients, the CAESY loop is going in the reception area," he said. "I run the general loop highlighting a variety of services."
Dr. Steiner said using the videos to educate patients does not eliminate the need for one-on-one educational time with the patient. But it sure can save some time. "Even though I enjoy visiting with patients, it's worthwhile introducing, giving a description of CAESY and following up," he said. "It's well done and it really fits into my family practice. I also like that the programs are regularly updated. So when hairstyles change in two or three years, I understand they'll keep that up. The programs wouldn't be as effective if they look outdated."
"Patient education is almost a must at this time," Dr. Pulec said. "All the manufacturers are realizing this. Patient chairs are being sold with built-in monitors. High-tech patient education is mainstream, whereas maybe five years ago it wasn't."
Orasphere Corp. recently released version 3 of Orasphere Patient Education software for PC networks, along with an Internet-enabled Orasphere On-Line patient education product that allows doctors to educate their patients and their families from their homes (www.orasphere.com). With a link from a practice's Web site or by entering a unique password on Orasphere.com, your patients can access videos on a wide variety of dental procedures.
Dr. Hughes likes CAESY's ease of use and time savings. "It's just a huge timesaver for the dentist. By the time I get to the operatory, the patient's already seen all the videos of the particular recommended treatment and doesn't have a lot of questions for me," said Dr. Hughes, who added computers to all of his treatment rooms in part to access CAESY. "Unless it's easy to use, you won't use it. So it had to be a couple of mouse clicks away in every operatory so I networked my whole office.
"Now I can recommend a CEREC crown and show the patient a 90-second video. Then the patients typically go to the front desk and they make an appointment. The guy who recommended CAESY told me that's how it would work. It sounds too good to be true, but it works."
Anne Mansfield, technology marketing manager for Patterson Dental Supply (CAESY), believes a well-educated patient is more likely to agree to treatment.
"People today are very informed not only about the world around them but also about their personal health," she said. "Many research their health options on the Internet, and patients expect the same type of comprehensive education from their dentists during visits. That's why interactive patient education programs such as CAESY are so important in the dental practice. The multimedia presentations thoroughly and consistently explain diagnoses, procedures, alternatives, and post-op instructions to patients, giving them confidence in their dentist's recommendations. That confidence and trust in the quality of the information being provided by the dentist leads to an increase in patient case acceptance."
Dr. Scott Lawrence, who has two thriving practices in rural Ohio, credits CAESY along with his EagleSoft practice management software with helping make his job a lot easier.
"Somebody comes in and they need a root canal," Dr. Lawrence said. "All they've heard is horror stories from their friends, because that's all people seem to hear about. They ask what a root canal is, and of course you can explain it verbally. But if you put that on the screen and show them what's going on, the broken tooth, show it in the x-ray on the screen, and then at the end you can print it…you can make a print for them to take home, a paper description of what a root canal is or how to take are of your extraction socket, or fluoride, or you just about name it. Then you can play a presentation and you then can actually put that presentation on a CD that they can then take home and play in their own computer. This is reality and people are just excited about it. They see that technology and I've had that now for about 6 months and they just see that and it's enlightening to me."