The Art of Practice Management's Dental Pearls
The Art of Practice Management
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Perio Therapeutics and Beyond
Marianne Harper
How to Find Hidden Energy in the Team
Marianne Harper
Who would think that a book titled "Fish" could be a really great motivational read? "Fish, written by Stephen C. Lundin, Ph.D., Harry Paul and John Christensen is just that. It is a parable about the antics of the Pike Place fish mongers in Seattle and how they can teach us ways to find a deep source of energy, creativity and passion within ourselves that will help us to learn to love what we do.

The authors explain that close to seventy-five percent of an adultís time awake each day is occupied by work related activities. If we do not feel happiness in what we do, thatís a terrible waste of that precious time. Life is too short for that. "Fish" provides four keys to change all of that.

The first key is that we should all "choose our attitudes." Not everyone has the perfect job and till the time comes when we can make a change in that direction, we need to make the best of the present time. If we begin a day with a negative attitude, then that contributes to a bad day. However, if we start each day by telling ourselves that we will have a good day, we find the energy to make it a good day. This not only benefits that individual, but that positive energy passes on to those around the individual, whether it be team members, bosses, or patients/customers, thus helping to make it a good day for everyone.

The second key is "play." There is so much energy in a playful spirit and this results in creating happiness in the people around you. Having fun makes the work hours pass quickly, itís a healthy way to pass the day and helps to make work a more rewarding experience. Our work can be serious business but we can still have fun with it.

The third key is to "make their day." To do this we must engage people, welcome them, and show them that we care. Doing this is outward directed – towards the patient/customer. According to the authors, "Focusing on making their day provides a constant flow of positive feelings."

We must be truly present with them to do this – interact with them, listen to them attentively, look right at them. This should not just be done with the patient/customer but should be done with all team members also. This is the fourth key. By doing this, we focus more on others and are better able to put aside our own problems. We will know that we have the power to truly make a difference in their lives. That is a very healthy feeling that helps to release even more energy within us.

I would like to share two great quotes from "Fish". The first is by John Gardner and is the following:

"Meaning is not something you stumble across, like the answer to a riddle or the prize in a treasure hunt. Meaning is something you build into your life. You build it out of your own past, out of your affections and loyalties, out of the experience of humankind as it is passed on to you, out of your own talent and understanding, out of the things you believe in, out of the things and people you love, out of the values for which you are willing to sacrifice something. The ingredients are there. You are the only one who can put them together into that pattern that will be your life. Let it be a life that has dignity and meaning for you. If it does, then the particular balance of success or failure is of less account."1

The second quote is from the authors of "Fish" that sums up their message beautifully:

"As you enter this place of work please choose to make today a great day. Your colleagues, customers, team members, and you yourself will be thankful. Find ways to play. We can be serious about our work without being serious about ourselves. Stay focused in order to be present when your customers and team members most need you. And should you feel your energy lapsing, try this surefire remedy. Find someone who needs a helping hand, a word of support, or a good ear – and make their day."2

This message needs to be posted in our practices as a reminder to all of its importance to the patients, the practice, the team members, and ourselves.

My advice to you is to buy this great little book, share it with the entire team, and reel in its message.
  1. Stephen C. Lundin, Ph.D., Harry Paul, and John Christensen. Fish, (New York: Hyperion, 2000), 104-105
  2. Stephen C. Lundin, Ph.D., Harry Paul, and John Christensen. Fish, (New York: Hyperion, 2000), 107

Occlusal Guards
Colleen Rutledge, RDH
About 95% of U.S. adults grind their teeth at night. There are many factors that contribute to bruxism, including stress, anxiety, anger, pain and frustration. Certain sleep disorders, as well as alcohol and some medications can trigger bruxism. These factors not only compromise the enamel but also contribute to periodontal breakdown.

Having said that, identifying bruxism is an essential, but often overlooked portion of a routine continuous care appointment. It is important for hygienists to consistently identify and document 'bruxing clues' during every recare visit. Obvious indicators of bruxing include: recession, wear facets, furcations, abfraction lesions, craze lines, cracked teeth, crowns with metal exposed, etc.

Cutting-edge practices realize that properly trained hygienists increase the number of occlusal guards that are recommend during routine hygiene visits.
  Insurance Alert
Do you struggle with creating narratives for claims that require narrative information? Consider creating narrative templates for the procedures that require narratives. These narratives can be created to address the main issues but simply leave blanks for patient specific information. Then just fill that information in and submit the narrative. It is a great time saver.
Cross coding from dental to medical presents some problems. It can be difficult at times to find a medical procedure code that truly explains a medically necessary dental procedure. What can be extremely helpful is to file medical claims with insurance carriers that accept our CDT codes. Our CDT code set is part of a medical coding system called HCPCS. So when you determine that a patientís procedure is medically necessary, call the carrier to check on coverage but always ask if they will accept CDT codes.
  Time Line
For those of you who have purchased my dental-medical cross coding manual, "CrossWalking – A Guide Through the CrossWalk of Dental to Medical Coding", it is now past time to update the manual with the new, changed, and deleted diagnosis codes. Please be sure to email me at to obtain your update.
January 1, 2011 – CDT Code biennial update (If you haven't updated your practice management software codes, be sure to do it ASAP) (If you haven't gotten a copy of the new code-set, do that ASAP)
January 1, 2011 – Medical CPT Code (medical procedure codes) update (be sure to update your manuals and CPT codes that are entered in your software)
July 5, 2011 – Medicare will require 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
October 1, 2013 – ICD-10 (medical diagnosis codes new revision)
January 1, 2014 – The date that the US government has chosen for requiring all medical and dental practices to be paperless

Favorite Quotes:
"The single biggest problem in communication is the illusion that it has taken place."
George Bernard Shaw

The quote above is so true Ė really think about its message. Consider this topic at your next staff meeting. Find ways to improve communication whether itís dentist to his or her self (taking the time to re-evaluate practice goals and policies), the dentist to the staff, the staff to the dentist, the staff to other staff members, and the team to the patients. Improved communication skills are vital to making good practices great practices.

Dental Humor:
What do you call a depressed dentist?
A little down in the mouth.

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The contents of this publication reflect the opinion of the authors only. This publication is for informational purposes only.
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