The Art of Practice Management's Dental Pearls
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Are You Taking Them for Granted?
Marianne Harper

To those of you who are dentists or office managers or staff that head a department, I have a question. Do you have a good staff? I bet that, for the most part, you answer yes to that question. My next question is – do they know that you feel that way?
Our business and personal schedules are often quite full and we tend to get so busy dealing with them that we often times don't even realize the great work that's going on around us – we get used to it. And that I believe is the crux of the problem.

Taking the staff for granted is something that I want you to really think about. As we should, we concentrate on caring for our patients and bringing them to optimal dental health. However, I want you to spend a little time looking around you as you work. Notice what your staff is doing – the extra steps they take to make your practice a success. Keep in mind that unappreciated good job performance will only last so long. It only takes a few seconds to acknowledge your appreciation – a simple thank you, a pat on the back, a "wow", a "job well done". Those are the simple expressions of thanks. A step up from that might be to keep some gift cards available and distribute them at certain times to show your gratitude. You may want to express thanks to the entire staff – so maybe a staff lunch or dinner. Any expression such as these will drive the message home that you value them. So put on your appreciation thinking caps to come up with some unique ideas to let them know that you believe they are the best. When staff feel valued they will continue to find ways to make your practice even more successful.

Fundamentals of Probing

Colleen Rutledge, RDH

A comprehensive periodontal evaluation is essential for proper diagnosis and treatment planning. Just as doctors expect to see current radiographs displayed during an exam, the same is expected regarding the periodontal evaluation. Here are the "Five Fundamentals" regarding periodontal charting/evaluations:

  1. Stop assuming the patient's periodontal health. All adult patients require a full periodontal charting / evaluation in order to properly assess periodontal status. This begins at approximately 18 – 20 years old but is determined on an individual basis.
  2. Do not cut corners! Always record six readings on each tooth. Spot probing encourages misdiagnosis - especially on new patients!
  3. Take the focus off "the numbers". Comprehensive periodontal evaluations include more than just pocket depths. Be sure to record: bleeding, recession, tissue color, loss of stippling, wear facets, furcations, abfraction lesions, exudate and clinical attachment levels.
  4. Probe at least once a year. This guideline reinforces the importance of continual assessments in order to maintain periodontal health and intercept disease in the early stages.
  5. Establish the value! Periodontal charting elucidates the true periodontal status to three parties: the doctor, the hygienist and the patient. Patients can not appreciate the service until the value is attached to it.

A review of periodontal probing technique and fundamentals is also helpful when launching a periodontal program. For a copy of Probing Technique and Fundamentals email me at:

In addition, there is currently a 20% OFF Pre-Sale Special on all of my DVD's & CD's until September 1, 2012! Please visit for more information.

  Insurance Alert
Dental – The ADA's Council on Dental Benefit Programs has announced that beginning with its next release, CDT 2013, the CDT Codes will be updated and released annually. CDT 2013 Codes will be effective January 1 through December 31, 2013. The new Code Set has numerous changes and revisions. One excellent source for your CDT codes is through "Coding with Confidence". This manual provides detail on how and how not to use the CDT codes and gives more detail than the ADA's CDT manual. To order "Coding with Confidence" download the Coding with Confidence Manual Order Form.
Medical – When cross coding to medical, if the diagnosis is uncertain, code the signs and symptoms.
  Time Line
October 1, 2012 – ICD-9 (medical diagnosis code set) will update. Purchasers of "CrossWalking – A Guide Through the CrossWalk of Dental to Medical Coding" - be on the lookout for my email blast that will provide information on the way to order the update. Medical insurance carriers will not accept outdated codes and will deny claims for that reason. I will be offering a less expensive update this year in an electronic format. So take advantage of the savings and keep your codes up to date.
Effective since 2011 – Medicare now requires that all physician and non-physician practitioners that submit Medicare claims must be enrolled in PECOS (Provider Enrollment, Chain and Ownership System) as well as all ordering and referring practitioners, or claims may not be paid. Practitioners can enroll online at
Effective since January 1, 2012 – All covered entities listed below are required to upgrade to HIPAA 5010 Standards which are new sets of standards that regulate the electronic transmission of specific healthcare transactions including eligibility, claim status, referrals, claims, and remittances. Covered entities may use a clearinghouse to assist them with complying with the rules.
Additionally, even though software vendors are not included in the list of covered entities, in order to support their customers they will need to upgrade their products to support HIPAA 5010 and NCDPD D.0 as a business imperative.
October 1, 2014 – The new date for ICD-10 implementation

Favorite Quotes:
"As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them."
~ John Fitzgerald Kennedy

Dismissing Patients
Check to be sure you are not violating anti-discrimination laws
Give 30 days' notice in writing and send by certified mail
Check on the rules with your contracted insurance plans

Points of Interest:
For those of you who have a home garden or even those of you who purchase fresh produce – your cucumbers may be of more importance than you realize. As you know, pickles are made from cucumbers. As you also know, Cleopatra is well known for being one of the great beauties in history. It is said that Cleopatra attributed her beauty to pickles.

Other interesting points of interest about pickles:
Pickles are native to India and have been around for over 5000 years
Christopher Columbus grew cucumbers for pickling in what is now Haiti
A cucumber is a fruit so, technically, the pickle is too
Pickles are mentioned in the Bible

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The Art of Practice Management
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