Acidic Foods Are a Major Cause of Tooth Decay

 

AGD Focuses on Tooth Erosion from Acidic Foods

At the Academy of General Dentistry’s upcoming annual meeting, speaker Dr. David Bartlett will discuss how to minimize tooth erosion caused by acid. He suggests patients consume acidic food and drink (soda, juice, fruit, yogurt, etc.) quickly and during mealtimes.

The focus is not on the patient’s diet, but simply on exposure to acid. Dr. Bartlett also suggests patients wait at least 20 minutes to brush teeth after eating acidic foods.

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Retirement for Dentists: These Days, Retirement is Totally Optional

Dental Retirement Survey ResultsOne in Five Dentists Can’t Afford to Retire

In a recent survey, The Wealthy Dentist asked dentists about their retirement plans. Two-thirds of our dentist respondents say that they expect to choose keep working part-time to keep themselves busy. Only 13% replied that they’re on track financially and will retire completely once their financial goals are fully met. One in five dentists would like to retire, but aren’t sure they will be financially able to afford it.

We also asked dentists about their target retirement age. And aren’t the specialists lucky! They’re planning to retire an average of six years before their colleagues practicing general dentistry.

What’s your target retirement age?
Average: 63 years old
General Dentists: 64 years old
Specialists: 58 years old

Check out the complete dental retirement survey results

Dentists Say Lead Is Dentistry’s Biggest Health Threat

Other Dental Health Concerns Include Mercury and Bisphenol-A

In this survey, we asked dentists how concerned they are about various potential public health threats linked to dentistry. Dentists’ concerns, in order, are:

General dentists versus specialists

  1. Lead in dental lab work
  2. Mercury in amalgam
  3. Bisphenol-A in composite, and
  4. Fluoride in water supplies.

General dentists had higher levels of concern on all issues than specialists. However, specialists and generalists agreed on the relative dangers of the chemicals covered in this survey.

Dentists’ thoughts

  • “I’d like to be doing all gold restorations.” (New Jersey dentist)
  • “All four of these need to be totally nailed down as to their safety, or lack thereof.” (Arkansas dentist)
  • “Two things that will bite dentistry in the butt are fluoride and amalgam if we don’t stop forcing them on the public.” (Idaho dentist)

Mercury

  • “150 years have not proved Amalgam to be dangerous.” (Arkansas dentist)
  • “Amalgams have saved billions of teeth!” (Washington dentist)
  • “A known toxin, no safe levels, should be banned.” (Louisiana dentist)

Lead

  • “Lead in dental casting alloy? Outrageous!” (Colorado dentist)
  • “Recent articles have debunked the worry over the amount of lead in ‘farmed-out’ crowns. Still, we need to monitor that work.” (California dentist)

Bisphenol-A (BPA)

  • “This stuff is everywhere. Composites without BPA just don’t hold up well.” (Wisconsin dentist)
  • “It’s probably not too dangerous, but don’t cast stones, Mr. Composite: you live in a glass house!” (New Jersey dentist)
  • “It’s ironic that many patients are removing long tested amalgam and replacing them with bisphenol composites of unproven safety.” (California dentist)

Fluoride

  • “It’s been shown to be effective, but we shouldn’t be medicating the whole population.” (Colorado dentist)
  • “The best public health measure ever instituted in this country for caries prevention.” (Texas dentist)
  • “Known to be toxic.” (California dentist)

Post your thoughts or read the complete dental public health threats survey results

Dentist Missed Appointment Policies

Dentist missed appointment feesLast week I told you about the $400 missed dental appointment fee that’s made headlines. While most would agree that’s excessive, lots of practices have policies designed to discourage no-shows.

This week, let’s review some of the ways dentists handle patients who skip dental appointments.

A multi-tiered approach

Many dental practices treat the first missed appointment quite differently than the fifth. Some offices do not charge until the third missed appointment. Others charge an increasing amount for repeat offenders.

“After school appointments, Saturday appointments, and school vacation appointments are considered to be ‘prime time appointments’ and are in very high demand,” read one pediatric dentist‘s appointment policies. “If a prime time appointment is missed we will no longer be able to schedule your child during that time.”

And the rest of the family is at risk once one misses an appointment. “We reserve the right to cancel appointments for family members who have upcoming appointments, once a fee of $100 has been charged to another family member.”

Other dental practices simply “fire” patients who have missed too many appointments, asking them not to return. (Not surprisingly, some patients become irate upon being fired.)

Raising prices

Some dentists find that a $20 or $40 missed appointment fee either doesn’t cover their costs or doesn’t prevent future missed appointments. As a result, more dentists are charging $75 for no-shows, and some charge up to $150.

Sometimes it isn’t a flat fee, but related to the cost of dental work. “Our fee is 50% of the scheduled service,” said one dental worker. “It has cut down on no-shows quite a bit, but it still happens occasionally.” Other practices charge by the hour of missed appointment time.

Some practices even charge interest on missed appointment fees.

Patient contracts

The Internet is rife with inquiries from patients who don’t want to pay their fee, asking questions like, “Can my dentist charge me for missing an appointment if I didn’t even know there was a fee?”

Some practices get around this possible objection by having all patients sign an actual contract outlining their financial policies. “A new patient fills out paperwork,” said one dentist office. “Like with any contract, it clearly states that they understand that if they do not give the required 3 business days notice, there will be a charge of $50.”

Other practices simply post their policies on their dental website and/or in their waiting room.

Patients just don’t want to pay

One patient offered this advice to others looking to get out of paying fees: “Whenever I get charged some sort of ‘late fee’ for a utility bill, I just call and ask if they would consider redacting the charge. I’ve never had anyone say no.”

“It also is with great discretion that we dole out cancellation charges,” said one dentist. “We know that by law they are uncollectable, but it prevents the bad apples from making future appointments and wasting more of our time.”

Cutting down on missed appointments

Calling patients to remind them of upcoming appointments can dramatically reduce no-shows. Multiple calls can be time-consuming but effective.

“We call our patients who have upcoming appointments 30 days prior to the appointed date to allow them ample time to make other arrangements,” said one practice. “We call again 2 weeks before the appointment, 5 days before the appointment and again 24 hours before the appointment. It takes a long time to make these calls but we find it is worth it in the long run because we usually see about 200 patients per week and have approximately 10 no shows or late cancels out of that number.”

What’s your policy?

How do you maintain profitability without alienating patients who have missed appointments? If you haven’t yet taken our survey on missed appointment policies, I encourage you to do so now!

Dentists Beware: The Government May Want To Tell You How To Manage Your Practice

dentists' hands in chainsThe North Carolina Senate recently upheld Senate Bill 655, which would require the North Carolina Board of Dental Examiners to examine all business contracts entered into by dental practices in their state.

No other state in the union has implemented such restrictions on dental practice management, or sought such inclusive authority over how dentists manage their business.

Talk about the far-reaching arm of the government!

As reported by Dr. Clifton Cameron in the Fay Observer –

“As a practicing dentist in Fayetteville, I know how this legislation will impact dentistry in North Carolina.

When my partner and I established our practice in 2008, we quickly realized dental school taught us much about clinical care, but little about running a business. And the dental industry, much like the rest of the health care industry, is changing and becoming more complex.

So like many small-business owners, we looked to outside companies to help finance the practice, manage billing, handle payroll, file insurance and execute other administrative tasks. The arrangement helped our dental practice operate so efficiently that we can charge lower rates and accept dental insurance from patients.

Instead of helping foster lower fees for patients and wider insurance acceptance, Senate Bill 655 would require dentists to personally handle all the administrative tasks of their practices.

The bill would forbid dentists from taking advantage of the types of business services that millions of small businesses use. Many dentists like me would be forced to spend less time on patient care and more time on managing the complexities of a modern dental practice.

Senate Bill 655 would give the Dental Board complete control of how dentists in North Carolina run their practices so they can keep fees charged to patients artificially high and insurance acceptance artificially low.”

The North Carolina State Board of Dental Examiners position on on Management Agreements with dental practices is as follows:

“The Board has become increasingly concerned about the expanding scope and nature of management company services and agreements, and their impact on the control of dental practices by the licensed dentists.

The bundled services offered by management companies typically involve some combination of (1) administrative management services; and (2) financial management services.

Based on its knowledge of the operations of dental practices, and after reviewing management arrangements with dental practices for almost ten (10) years, the Board has identified features of management arrangements which it has determined to be highly likely to create a situation where the ownership, management, supervision or control of a dental practice is impermissibly conveyed to an unlicensed person or organization because either separately or when bundled, those features interfere with the licensed dentists’ professional decision-making and their exercise of clinical skill, judgment and supervision in the dental practice.”

Have you read about this story? What are your thoughts about the government and a State Board of Dental Examiners dictating how you administrate your dental practice?

We look forward to hearing your thoughts on this subject.

For more on this story see: Op-ed: Legislation would restrict dentistry in the state and the North Carolina State Board of Dental Examiners position at www.ncdentalboard.org (opens in a pdf file).

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