hello everyone and welcome in to chairside live I'm your host Megan strong in this episode we
have part one of an exciting interview with public speaker author and dental practice consultant dr.
David Schwab then it's time for another edition of across the chair where our own will Schmidt
is discussing his tips for selecting the right impression tray for each patient but first dr.
Neil Park director of clinical affairs here at Gladwell Laboratories recently interviewed
dr. David Schwab they were at the academy of osseointegration 2016 annual meeting so today
we're taking a look at part 1 of this three-part interview series check it out I'm dr. Neil
Park director of clinical affairs for Glidewell laboratories and we're here in San Diego at the
annual meeting of the Academy of osseointegration my guest is David Schwab PhD David Schwab is a
motivational speaker a consultant and an author who helps dentists grow their practices educate
their patients and train their teams so that the practices will reach their full potential
his website is David schwab.com welcome David Thank You Neil pleasure to be here let's get
right to it so the big question how does a guy with a PhD in English get into the field
of dental practice management Neil it was my good fortune I was actually finishing my PhD in Chicago
at Northwestern when I heard about this job at the ABA so I went over to the a da and they were
looking for a skill set they wanted somebody who could analyze somebody who could write somebody
who could do presentations and that sort of thing and it's sort of meshed so I did finish my PhD and
I went to work for the a da and I did things like accreditation I was administratively in charge of
the accreditation of all the specialty programs in the United States as well as GPR programs AGD
and so forth then I did marketing for them when I left I was actually director of marketing and it
was a really great experience was my residency to go all over the place and learn a lot about
dentistry after that I was executive director of the American College of prosthodontist and iock
started and continued to this day a very full speaking schedule I do consulting for dental
practices and try to help the practices grow and they're full potential great so you and I of
course have been friends for a long time and maybe if you shared with our viewers the story of how
we met and then how we've worked together over the years it's interesting because back in the
day you know we're both living in Florida we're living about 10 minutes apart from each other and
you were always very thickened with a lot of very fine companies over the years and I remember you
were working for a very famous company and you called me because they were doing a big meeting
about 10 minutes away and you said can you come to this meeting and talk to all these sales reps and
motivate them and get them out there so we had a great time at the meeting and I think a lot
of good things came out of for both of us and then over the years I've sort of followed you
as you've been on the inside of a lot of these companies well I've been a consultant sort of
working on the outside but the paths have crossed and now I'm thrilled that you're both Glidewell as
a matter of fact now it Glidewell we both have a lot of mutual friends who've been with the
business for a while and a really great folks well that's great that's great so as you work
with your clients over the years what are some of the challenges that you found in marketing
dental implants of course dental implants are just a wonderful modality but I find that a lot
of patients just don't know what they don't know they don't appreciate the benefits and it's hard
for people to really think ahead and imagine the life-changing benefits of dental implants before
they have them and a lot of patients I think get sticker shock if you ask patients if you
had to go to the dentist and just have a cleaning and exam and x-rays and so forth how much money
do you think you'd spend they would say well I'd probably spend in about three figures would be in
the hundreds of dollars which is true well if you had to go to the dentist and you needed something
more extensive like if you needed a crown how much might that cost and most people know that
now we're looking at four figures we're looking at something north of $1000 but within that range but
when people have a large implant case and they sit down they find out that it could be a five figure
case I think that really throws them and they get sticker shock so that the challenge is to talk to
the patient not just about a missing tooth and not just in dental terms about oh well the opposing to
we have to worry about super-eruption and we have to worry about missing teeth and malocclusion and
shifting teeth and periodontal disease all very important points but we have to explain
to them that there's an enormous quality of life benefit and people want to live longer
but they want to live better and once they find out about the quality of life benefit then they
become intrigued by it and of course we've got wonderful testimonials from people who have had
dental implants and we use those testimonials to help reassure people so they will in turn move
forward with their treatment you know David used the term sticker shock and I've heard dentists use
that it's that sort of a car analogy it is right and you know and I've heard Dennis say to their
patients that you know it costs less than a car but it's gonna it's gonna last you many years and
provide you improvements in your quality of life do you think that's a useful analogy for Dennis to
use I do like the car analogy Neal but I have to tell you something I think the car analogy needs
to be strengthened and needs to be a little bit more specific so I do a little research on this
and look this up turns out that the average person in the United States now keeps a car for about 71
or 72 months which is about six years does a wide variety of course but that's an average
and the average price of a car in this country now is between 33 and 34 thousand dollars again
a big range but that's the average so let's just do the math if somebody buys a car and what we
will call year one and then they buy another one in year six another one in year 12 another one in
the year 1800 over the course of those eighteen years they've bought four cars we have to allow
for some trade-in value on the cars but then we also have to allow for some appreciation of
price because there is an inflation factor but no matter how conservatively you do the math over the
course of that 18 year time period that average person will have spent over a hundred thousand
dollars on automobiles now what do they get well they get convenience and they get transportation
but if they spend five figures on their implant case they get quality of life benefit they get
aesthetics they get function and they also get a tremendous psychological benefit and what we
have to tell the patients is that over this 18 year period you can extrapolate that forward for
25 or 30 whatever you want they're spending all this money on automobiles which is important to
their life but not quite as important as a body part so when they spend their money on dental
implants this is something that will last not six years not 12 years but usually decades and very
often as you know a lifetime so when we position it that way and we use the car analogy that way
it it's obvious that the dental plants are a fantastic value for the dollar and the benefit
of improved quality of life just can't be beat so David here's what our viewers want to know what is
the secret to an effective case presentation for dental implants that's probably a full-day lecture
Neil but let me let me just summarize it for you this way I use what I call a lead system le ad
and lead stands for listen e stands for empathize a is assur and D is direct and let me just give
you a quick example on each one when I say listen let there find people working in dental practices
they know about active listening they're good at this doctors and staff are good listeners but you
have to listen carefully what the patients are saying for example one of the questions I like
to ask patients who come in they may have been missing tooth or multiple teeth for years and a
great question asked them is what motivated you to come in today why are you here now and the
answer to that question is going to be something we can connect to the case presentation their
motivation ultimately to their acceptance when we talk about empathy it's really interesting to me
we have again find people who do empathize with their patients I know that but it's not enough
to feel the empathy you have to demonstrate the empathy and I've heard patients call on on the
phone and we've listened to conversations where the patient says I'm embarrassed or I'm upset
or I have difficulty chewing or even I'm in some discomfort and someone says do you want to come in
on Tuesday or do you want to come in on Wednesday and the appropriate response is I'm sorry to hear
you're having problems you came to the right place we're gonna take good care of you so that empathy
and that connection is very important the a stands for sure we're gonna get people who come in and
they say I've never had anything like this before and this is gonna hurt it's gonna be painful I
don't know what to expect and we need someone to say this is what we do to keep you comfortable or
I can assure you the doctor has done thousands of these procedures and the patient's praise him not
only for being an expert but also for being very gentle and the D is direct we want to be low-key
we want to be respectful to the patient but we also want to direct them they're coming looking
for guidance so we want to say to them what more information do you need so you can make a decision
what option would you like would you like to schedule can we get you in so we have to direct
them so that we just don't leave the conversation hanging but that we're saying let's let's get to a
decision and if you more information we'll provide it but we're being low-key but we're also sort
of gently guiding them in the right direction so it's it's it's listen it's empathized it's a shore
and it's direct and we put that into a package for them there are other things of course that go into
it but just to give you a succinct answer to your question those are some specific things we talked
about so that found that sounds like a fairly structured conversation do you recommend the
doctors and their teams use scripts when talking to patients about dental implants I get a lot of
questions about scripts but my feeling is that we have to use great verbal skills and so often the
team tells me something contradictory they'll say you know we want the right words we don't
want to be stuck and not know the right words but at the same time we don't want a script that
we have to read that says thank you for coming in today and so forth I say of course you don't
want that you want it to be somewhat spontaneous so my phrase is rather than calling it scripts I
call it talking points I want to give you certain talking points that you can use and that you can
feel comfortable with but you can weave them into your own conversation so for example if a patient
says you know it seems very expensive I don't know if I want to do it I have to think about
it that's a legitimate thing for the patient to bring up and I'm just gonna sort of pull this
out you realize this is within the context of a longer conversation but one of the things we can
say to patients if we have certain verbal skills in mind is that the proposed treatment will never
be more conservative more cost effective or less invasive than it is today let me break that down
a little bit conservative is a good word to use not in the political context of course but in
the context of conservative as opposed to radical nobody wants radical dentistry then we say it's
more conservative it's more cost effective which implies value it also implies we're not saying
this but the longer you wait the more it's going to cost so cost-effective is a good word and less
invasive because people want to know can I have the minimum amount of Dentistry not the maximum
amount of Dentistry so if we keep those words like conservative and cost effective and less
invasive in mind and weave them into our own sentences with our own personality we've got
something very strong to say to the patient but at the same time it's not trying to make it up
on the fly thank you for that dr. Park and we look forward to the rest of your interview with
dr. Schwab but now it's time for registered dental assistant will Schmidt to talk to us
about choosing the right impression tray in this segment we like to call across the chair
thank you so much Megan well today I want to talk about selecting the proper impression tray
for your ideal final impression it is critical to select trays based upon a per patient's need
basis and stray away from the habit of simply picking trays that are readily available at that
time a little pre-planning is going to go a long way when it comes to the quality and fit of your
patients final restorations I would like to go ahead and show some examples of recent patients
seen in my operatory and talk about the reasons why we chose their specific trace so in the case
of this patient we decided on a full arch metal tray for number 30 due to the lack of posterior
support since number 31 and 32 we're missing we do not want an opportunity for the bite to collapse
of course an opposing full arch impression and a bite registration will follow after the final
impression the main benefit of a metal tray of course is its rigidity it will not bend and
warp your impression even through pouring up and models in this case however the patient had some
bony exhaust osis apical of the lower interiors which momentarily locked the tray to the arch in
hindsight a custom tray that relieves undercuts may have been a better option it is for this very
reason I want to reiterate my rule of checking and double-checking prior to tray selection as
you can see once removed this impression is very serviceable and the patient's restoration was a
success so here we have a similar situation both molars are prepped and no posterior stops are
here to prevent bike collapse in this case as well a full arch is necessary by planning ahead
checking for undercuts we verified that none were present and the tray was removed with ease this
patient has a very unique arch anatomy it is very tight and oblong with an extremely deep palate we
tried a multitude of precise trays however none would fit his arch shape without being warped or
bent of course I always avoid warping or bending final impression trays interestingly enough I did
have to warp a plastic precise tray just to take the impression for his custom tray then I had a
couple custom full-arch trays made in case of any retakes I prefer a custom trays with holes
placed in the acrylic for extra ability to lock and pressure material to it as a rule try your
tray in the mouth prior to impression and make sure the walls of the trade do not invade too
much into the mucosal fault if needed adjust your tray with an acrylic burr if you find this to be
an issue after all your lab tech is merely working off of a model and doesn't have the ability to see
folds or tissue this number 27 anterior crown impression was fairly straightforward when it
comes to an interior most times less is more a triple tray impression made this capture
easy to fill bite and remove notice I selected a metal rim trail versus a plastic tray due to
the rigidity of this material this impression was successful on our first attempt in your
search for a great assortment of precise trays I like to suggest GC America products as far
as selection is concerned if you're not using a custom tray you'll find what you're looking for
there well I hope you enjoyed a different perspective on impression tray selection I
want to leave a lasting impression on you with these two very important points make sure to
plan ahead and on a per patient needs basis and mimic the tray you'll use for the final
impression with the one that you will use for your permanent restoration Global laboratories
is happy to assist your office with fabrication of a custom impression trays as well as our very
own capture VPS and pressure materials back to you Megan that was great well thank you so much
well that about wraps it up for this episode of chair side life on behalf of everyone here at
Glidewell Laboratories we thank you for watching and I'll meet you right back here next time
you