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Are Your Patients Included in Your Training Plan? by Carolyn Friedman

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Training does not just involve staff members, it should also include your patients. We get so focused on getting through the schedule for the day that we forget to educate our patients on the part they play in the success of their treatment. When starting patients in orthodontics, it is necessary to make sure they understand their part in the success of treatment. The final results cannot be achieved without patients being onboard and understanding their responsibility.

Appointment Times

Patients need to be on time for their appointments, but your office needs to set an example. If you are always running behind on your schedule, why should your patients show up on time? Remember, you can only expect your patients to be on time for their appointments if you run on time. It always pays off when we are respectful of our patients' time. Your schedule must be realistic – is what you have established as your everyday schedule obtainable? When seeing new patients, it is even more essential for them to be seen on time. They are forming their first impression of the practice and deciding if they want to begin their treatment with your practice. You only get one chance at a first impression, so make sure you don't lose a patient because you are running late. Therefore, don't let latearriving patients ruin your schedule. If you continue to see patients that always arrive late, you are training them that it is OK to come whenever they want. You set the tone, so inform your patients of your scheduling policies and set a good example by being on time.

Emergencies

We have the ability to control our schedule so much more than in other professions. Orthodontics has very few true emergencies. Most emergencies can be taken care of within several days time, not necessarily the minute someone calls. Again, this is training and educating your patients to understand this so that they don't expect to get in for a repair within the hour. If your receptionist has knowledge of clinical procedures, she is more able to determine which are the true emergencies and schedule accordingly. Some breakages can be handled temporarily by the patient, eliminating the need for an immediate appointment. This way of handling emergencies will also keep your schedule from becoming total chaos.

Missing Appointments

A problem in many practices is patients who do not come in for their regular appointments. The orthodontist's treatment estimate is based on the patient keeping their regularly scheduled appointments. Every time a patient goes over the estimated treatment time, it costs the practice and the profit starts to decrease. Confirming appointments for patients helps them to stick to their schedule and their treatment progressing. Confirming appointments should be considered a courtesy, not as something where we are at fault if they don't show. Patients want to hold us responsible instead of them taking ownership of showing up. At the beginning of treatment, make sure your patients are aware that their estimated treatment time is based on them following appliance care instructions and making their scheduled appointments, and that missed appointments might result in extended treatment time.

Oral Hygiene

Some patients might believe that since they are seeing an orthodontist regularly, it's not as important to see their general dentists. All practices need to review their information and procedures to ensure that patients are fully informed that during orthodontic treatment it is necessary to continue to see their general dentist. I have become aware in my consulting that practices have patients who state they were unaware that they were to continue with regular cleanings. The operative word is "unaware." We are in the days of patients taking no responsibility. Make sure that somewhere in your agreement that this is covered and you have their signature on that form.

It's great to recommend that during orthodontic treatment patients see their hygienist every four to six months for cleanings. As we all know, if a patient has a problem with oral hygiene, it complicates our job tremendously. Teeth do not move as well with swollen and puffy gums. Also, our area hygienists and dentists really appreciate it when they hear that we recommended this to all of our patients.

Restrictions and "Allowables"

The other training area involves making sure that your patients understand their restrictions concerning what they will be able to eat. I like to have not only a "No-No" list with the foods to avoid, but also a "Yes-Yes" list, which I give to patients, that gives them some direction on making good choices. Anytime that you can turn a negative into a positive, do it. Whatever you can do to get patients to follow instructions provides benefits in two ways: parents do not like to have to return for repairs, and you reduce the number of emergencies.

Procedural Patient Education

Educating patients after procedures can also help with reducing emergencies. Make sure you inform your patients of everything they need to know about their procedure or appliance. If your bonding process requires the patient to avoid items such as carbonated sodas for a period of time, they must be informed and know the impact of not following instructions. The first 24 hours after a bonding procedure is when there is the greatest chance of a loose bracket. Even when they brush, they should be careful or they can knock off a bracket if they apply too much pressure and force.

Orthodontic Insurance

Orthodontic insurance is unlike any other type of insurance coverage. The majority of the companies issue a lifetime maximum orthodontic benefit for each individual. Most parents and patients do not understand how orthodontic coverage works.

If you help educate and explain how it works, there will be fewer problems later. Many patients come into the office thinking that their coverage is 50 or 80 percent of their entire orthodontic fee. Once you explain how it really works, it will be easier for them to stay on track with their payments.

Every patient needs to realize that the entire fee is their responsibility. If they lose coverage or anything changes with their benefits, they do owe the total fee. Filing insurance claims and taking assignment of benefits is a courtesy for patients.

Conclusion

Evaluate every aspect of your practice. Are you covering information with your patients on how their insurance works, your scheduling policies, how you work in emergency appointments, and what care they must take after a procedure? Most people remember more of what they see than what they hear. Where possible, provide the information in writing. The more your patients are informed, the more your expectations and the expectations of your patients will be met, ensuring a positive experience for everyone.

*This article was made possible through the support of an Education Grant from G CARE, an educational alliance supported by Dentsply GAC.

Author's Bio
Carolyn Friedman continues to work in the same progressive orthodontic practice that she has worked for 39 years. Beginning as an orthodontic assistant, and having worked in every area of the orthodontic office, she currently is the office manager and treatment coordinator.

She is the founder of OrthoAssist, a business focused on orthodontic consulting and training of orthodontic staff members. She is also the author of the OrthoAssist Library, online interactive programs consisting of training programs for all areas of the practice.

Carolyn is a continuing education provider for the Florida Board of Dentistry, conducting educational programs for hygienists on orthodontic appliances, their application and care.

She is an international speaker on orthodontic assistant training, teamwork and practice building. With all of her endeavors, she continues to work for an orthodontist, which helps her keep current with what is happening in orthodontics. She can be contacted at orthoassist@comcast.net.
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September 2025
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