Dental Diaries: Patient loyalty?

2012 04 16 15 06 39 236 Doniger 08 70

We had a very interesting situation occur in our office recently. I am sure I am preaching to the choir on this, especially for those who accept dental benefits, but I will tell my tale anyway.

We had two patients of record decide to leave our practice because of their dental benefits. One had been coming to our practice for more than 18 years, and he called to say since we were not on a specific dental plan he would have to seek dental treatment elsewhere. The other patient, a "newbie" of only five years in the practice, decided to leave because his former dentist did not charge the remainder balance to his family.

Sheri B. Doniger, DDS.Sheri B. Doniger, DDS.
Sheri B. Doniger, DDS.

As those of you who do take dental benefits know, it is a fickle world out there. Some are discounted plans that allow the participant to enjoy a discounted fee from our normal treatment fees (but still receive the same quality treatment with the same quality materials). There are also those on a normal indemnity plan, where partial payment is given and remainder balances are paid.

Sheri Suggests: GC America's MI Varnish

GC America's MI Varnish

GC America has come out with an amazing fluoride varnish, MI Varnish. Not only does it look great on the tray (just like a little strawberry sitting there), but it tastes great and is easy to apply.

MI Varnish also features the Recaldent (CPP-ACP) technology, which helps rebuild and remineralize teeth. The casein phosphopeptides (CPP), which occur naturally in milk, binds to teeth, mucosa, and biofilm, while the amorphous calcium phosphate (ACP) strengthens enamel. Clinically, it will enhance acid resistance of enamel with the increased calcium and phosphate ions, in addition to the fluoride that is retained much longer than gels, foams, or rinses.

MI Varnish can also reduce sensitivity due to tubule penetration and sealing. MI Varnish does not clump, easily flows into interproximal areas due to low viscosity, and is patient-friendly. It goes on thin and it is more translucent. It is ideal for all patients, regardless of their caries risk.

"There are many fluoride varnishes on the market today, but MI Varnish with Recaldent delivers a high release of fluoride, calcium, and phosphate ions that helps to enhance the enamel's ability to resist acid and contribute to higher calcium and phosphate levels in the saliva," said Gina Durkin, product manager, preventive for GC America. "Working together, the fluoride, calcium, and phosphate provide an extra boost of protection for patients with moderate to high caries risk. MI Varnish is safe, effective, and its unique unidose contains enough varnish for a full adult dentition."

MI Varnish, used in conjunction with MI Paste and MI Paste Plus with Recaldent, results in a well-rounded treatment plan for strong, healthy teeth. Our patients love it!

The first patient I mentioned above, the one who had been with us for more than 18 years, went onto a plan that practitioners sign up to participate in and the dentist potentially receives a portion of the fee and is not allowed to collect the remainder. The other patient had a fantastic dental plan but did not want to pay anything out of pocket.

It is very frustrating out there, looking at dental reimbursements. One dental plan, a major insurer in my state, just took on a very large group. This plan now pays a third of any service rendered. Interestingly, larger-fee items, such as single tooth prosthetics, are paid at a higher rate, but those are few and far between. As practitioners, we are not allowed to know any of the reimbursement rates, as there has been fraudulent use of these plans, but we have some knowledge when we contact the companies for their explanation of benefits and when we send in the preauthorization for treatment.

Still, the loss of two patients is not something dental practices want to see in this economy. Both patients were very polite when they said they wanted to leave the practice, but it is still concerning that there is little to no loyalty in this time. I had another husband and wife recently tell me they were not able to spend $80 on a "filling" and so were considering their options.

The reality is that patient longevity may be a thing of the past. With all the daily deals out there such as Groupon, there are many younger patients with limited funds (even those with dental benefits) who would rather use the $49 special and go from dentist to dentist than stick with one practice. If they have dentistry to do, they usually put it off.

Regarding the patient whose former dentist only took what the benefits company paid, I don't know if that is truly ethical. We are supposed to bill everyone the same. If we take some money and call it a day from some people and not all, then our fees are random.

The bottom line is: Once a patient decides to leave, he or she is gone. This patient did not appreciate the style of practice, ethical treatment, or ambiance of the office. One never knows the real reason.

This is not to say all of our patients are not loyal. This is what we base our recare system on: returning patients. I am thankful for my loyal patients and wish the two who left the best in finding a new dental home.

Sheri B. Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. Most recently, she was the editor of Woman Dentist Journal and Woman Dentist eJournal. You can reach her at

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.