Friday, January 23, 2015


The Ad Council and The Partnership for Healthy Mouths, Healthy Lives have combined to produce a series of English and Spanish-language PSAs, Kids Healthy Mouths.  The two-minute PSAs, aimed at teaching a child good tooth brushing habits, are posted on the Ad Council website,  Families visiting the website can sign up for a mobile program, part of the 2min2x campaign that texts users twice daily to remind them to brush their teeth.  Additionally, a “Toothsavers” mobile game app is also available on the site.

For more information about the Kids Healthy Mouths campaign, go to site to follow the campaign’s social media communities on Facebook  (  and Twitter (@brush2min2x).

Monday, January 19, 2015


One of the great annoyances for the dentist, for the dental team member(s) who handle scheduling, and for the hygienist in the case of Recare appointments, is broken (BA) appointments and cancelled-not-rescheduled (CA-NR) appointments.  Failed appointments plague many offices, costing time and money.  A system for processing BAs and CA-NRs is a necessary factor in effectively managing your practice.  The office that pays little to no attention to BAs and CA-NRs finds patient count dwindling and often wonders why.
A written protocol is an excellent training tool for new team members and a useful reminder for seasoned staff.  Unless a standard process is in place, BAs and CA-NRs get absorbed into the busy flow of a day’s patients and are soon forgotten.
Consider the following steps as you and your staff put your BA and CA-NR protocol in writing:
Enter into the computer, preferably the chairside computer in the treatment bay,  the treatment plan and the next appointment, including the next Recare  appointment, for every patient.  Doing so means that at the end of each month a  list of all BAs and CA-NRs can be generated and contacted for rescheduling.
Appoint each patient at today’s appointment for one subsequent restorative or  hygiene appointment.  Suggestion:  do not give a series of restorative  appointments.  If a series of restorative appointments is made, lay people- patients who have no idea that restorative work will be done in sequence often  think,  “It’s OK to break my next appointment with Dr. Jones because I have  another (others) already scheduled---not showing for one appointment won’t  matter.”
When a BA occurs, call within 10 to 15 minutes of the no-show.  Either a  business staff member, the dental assistant who was to work with that patient, or  the hygienist if a Recare appointment, can make the call.  A non-confrontational  way to inquire:  “We were worried about you, Mrs. Smith, when you didn’t come     for your 3PM confirmed appointment.  Dr. Jones asked that I call to make sure  there’s no problem.”  The staff member should then be quiet, allowing the patient  to explain.
Reappoint the patient as soon as possible if a BA is unusual for this patient.  If,  however, the patient has a repeated pattern of BAs, consider reappointing in four  to six weeks. This gives the subtle message that Dr. Jones’ office is so busy that  he cannot see that patient for several weeks.
Some practices choose to charge for a BA, informing patients of that fact when  the next appointment is made.  Others find doing so counterproductive and  annoying for patients.  These offices prefer to send an email or a note via USPS  mail to the patient who frequently breaks appointment with some version of this  message:  “While we do not currently charge for broken appointments, they are  very costly.  Dr. Jones and his assistant set aside special time to care for you;  and medicaments, instruments, and equipment are prepared, ready for your  treatment.  Additionally, another patient who could have used that appointment  time has been delayed.  We appreciate your choosing our office to meet your  dental needs, and we work diligently to give you the best dental care available in  a timely manner.  We respectfully request that you make every effort to keep all  appointments or call our office at least 24 hours prior to reschedule.  We will  be happy to reschedule your appointment for ________________.  Please call  our office today.” 
Note all BAs and CA-NRs in the patients’ chart, computerized or paper.  Call  these patients by the end of the month in an attempt to reschedule.
Inactivate those patients who simply cannot be reappointed within four to six  months.  Upon inactivation, notify the patient in writing via “Certified Mail, Return  Receipt Requested.”  This serves as important documentation should the patient  later claim “patient abandonment.”
Some combination of these factors can compose your standardized BA and CA-NR system.  The dentist and one or two experienced team members can write BA/CA-NR protocol to be shared with the entire team at a staff meeting and frequently thereafter.

Friday, January 16, 2015


While much media attention has been diverted to other topics, ebola is still an international health threat of which dental professionals need to be aware.  The American Dental Association is in contact with the CDC (Centers for Disease Control) and other agencies to procure up-to-date information for dentists.  The address of the ADA online ebola resource center is given at the end of this blog.

While the following brief comments are NOT meant to offer advice on a topic of such serious consequence, be aware that dentists are advised to take a medical history including a travel history from patients with symptoms of a viral infection.  It is further suggested that dentists delay for at least 21 days routine dental care for patients returning from the West African countries of Guinea, Sierra Leone, and Liberia.
Palliative care for dental infections and pain can be provided within the 21 day period if the dentist first consults the patient’s physician concerning symptoms.  If treatment is done, the dentist must protect himself/herself and staff members with precautions beginning with physical barriers such as masks, gloves, face protection, and gowns impervious to fluids and follow many other rigid protocols as well.

For more information, go to the ADA's Ebola Resource page.  Also obtain the CDC Health Care Provider Preparedness Checklist for Ebola VirusDisease.

Saturday, January 10, 2015


Ransomware??  What is it?  Ransomware is a method by which computer hackers deny a healthcare provider access to his or her own electronic patient records.  Ransomware describes an event in which files containing patients’ protected health information (PHI) are attacked, corrupted, and made inaccessible.  The healthcare office later receives a “ransom note” offering restoration of access to patient records in exchange for payment of ransom money.

In case your office is hit by this growing threat, remember HIPAA regulations require reporting this and all other breaches of patients’ PHI.  Additionally, dental practices and other healthcare providers must identify potential threats to patients’ PHI and implement steps to avoid any breaches of security.  Among the steps should be frequent back-ups of patient information with safeguards in place to protect back-ups.  Many dental offices outsource IT work to an expert to be certain all aspects of security for electronic records are in place, current, and working properly.  If you are not certain that your patients’ PHI is fully protected, consider  contracting with an IT professional.
For more information concerning protection of patients’ PHI, go to the Department of Health and Human Services website and view the Security Rule Educational Paper Series.

Sunday, January 4, 2015


The Consumer Price Index (CPI) measured inflation at 1.7% between September 2013 and September 2014.  However, dental practice overhead costs rose at a significantly higher rate due to several factors.  Thanks to the 2.3% sales tax implemented on medical devices under the Affordable Care Act, costs for new dental instruments and equipment have increased approximately 5%.  Staff compensation packages have increased due to raises or periodic bonuses plus dramatic increases in staff health care plan premiums, 20% or more in many states.  Further, as an increased number of dental offices have chosen to accept managed care plans in order to stay fully busy, reduced managed care fees have cut into profit levels.

With these and other factors in mind, practice management advisors concur that an appropriate fee increase for 2015 will be 3% for those offices which have maintained a fee schedule commensurate with their area.  Those offices which have neglected fee adjustments for longer than a year may need a more significant increase in order to “catch up” and maintain a reasonable level of profit.  Annual fee increases are advised for individual practices.  Additionally, fee increases raise the fee profile for all practices in a certain area, thereby influencing the fee schedules offered by managed care company contracts and state Medicaid reimbursement levels.

Thursday, January 1, 2015


Success seems to be created with action.  Successful people keep moving.  They make mistakes, but they don’t quit.”                                                                                                                                                                                            Conrad Hilton, founder of Hilton Hotels

“No other game combines the wonder of nature with the discipline of sport in such carefully planned ways.  A great golf course both frees and challenges a golfer’s mind.                                                                      Tom Watson, Hall of Fame golfer

“I know that fear is an obstacle for some people, but it is an illusion to me…Failure always made me try harder next time.”                                                                                                                                                     Michael Jordan, former NBA superstar

“None of us is as smart as all of us.”                                                                                                                                                                    Ken Blanchard, lecturer, instructor, author of                                                                                        numerous business books

“You are today where your thoughts have brought you.  You will be tomorrow where your thoughts take you.”                                                                                                                                                                                       James Allen, author of As a Man Thinketh

“Do nothing from selfishness or conceit, but in humility count others better than yourself.  Let each of you look not only to his” (or her) “own interests, but also to the interests of others.”                                                                                                                                                                                                                           The Apostle Paul of Tarsus

Tuesday, December 30, 2014


In a previous blog, we talked about KENYA SMILES: Improving the Oral Health of Children, A Unique preventive care model easily adapted throughout East Africa and beyond.  KENYA SMILES will be replicated throughout Kenya and other East African countries and taken next to Myanmar.
Among its activities, KENYA SMILES has delivered dental care supplies and educational materials in durable, colorful backpacks and presented oral health lessons to approximately 5000 Kenyan children.  Further, the program has provided nutrition counseling and energy-efficient cook-stoves to hundreds of mothers, health care providers, educators, and care givers in the slums of Nairobi and in rural areas near Mt. Kenya.  Professionals working with KENYA SMILES have created dental curricula in English and Swahili for use in schools, presented four mobile operatories and equipment to the Kenya Dental Association, the Nairobi School of Dental Sciences, and Meru Dental Services to treat children in underserved areas and coordinated two high level exchanges between professionals in California and Kenya.

We at Practicon stand up to cheer this major Global Grant Project of Rotary International led by RI Districts 5160 (North Central California), 9212 (Kenya), and 6150 (North and Central Arkansas).  It is our pleasure to support KENYA SMILES.  For more information, please contact Rotarians PDG Laura Day or Sheila Hurst, Ed.D., at