ORTHOBITES “goodie” hygiene pouch; a picture showing how improper brush- ing causes decay and decalcifica- tion; and a “Braces Owner’s Manual”. When a patient neglects his/her teeth Fig. 2 If, for example, you are sending out direct mailers, work your zip codes in a circle so every two or three months, the prospective patient is reminded of your office. Keep planting seeds. Some of them eventually blos- som into great patients. Completing Cases Once you have orthodontic patients coming in from internal as well as external sources for consultations and evaluations (you’ve made the sale, taken the records, gotten signed financials and consents, placed separators), it is time to lock and load! You bracket and band the patient, place your initial arch wire, go over oral hygiene instructions and schedule to see them either to band the sevens in a week or six weeks to change the arch wires. Six weeks elapse and the patient is sitting in your chair. You look in their mouth and you cannot see the brackets because of cakes of plaque. Also, they have four brackets off, one band is loose, and they have lost their upper arch wire. Welcome to orthodontics! Actually, most of the time, this can be prevented with simple oral hygiene instructions and dispensing the proper oral hygiene products. Figs. 2-5 show one of my assistants instructing a patient on oral hygiene after initially placing brackets and bands. Obviously, if your patient is a child, you must also involve the parent about the importance of oral hygiene in their child’s mouth. Also shown is the while in orthodontics in our office, we have a “bad cop – good cop” approach. Figure 6 demonstrates the “bad cop” way.We paint the “purple monster” (plaque disclosing solu- tion) on their teeth and explain that this is bacte- ria. We further explain that bacteria as other living creatures all do three things: eat, pee and poop! It works ladies and gentlemen. We tell them to go brush the pee Fig.4 Fig. 5 and poop off of their teeth. No one wants pee and poop in their mouth! The patient usually comes back pretty clean from the brushing station. The “good cop” approach is in the form of a program we call “Ortho Bucks”. Fig. 7 shows a young lady with a fist full. All of the children and Fig. 6 Fig. 3 some of the adults participate in this program. They can receive ortho bucks for making the “A” or “A/B” honor roll; for not having a bracket off; for clean teeth; for their birthday; for doing nice for someone else; and for anything we can think to reward them for. They in turn accumulate them and exchange them for t-shirts, Chili’s coupons; McDonald’s gift certificates coupons; Chick-Fil-A coupons; and other items. Positive reward and praise goes so much further on children than negative scolding. However, we often have to employ a combination of both. Selling Needed Products As Convenience It is so important to stress to the patient/parent about regular checkups and cleanings. And I recommend taking bitewings on at every hygiene appointment. Recurrent decay can often be picked up on bitewings gingival to the molar bands. I recommend fluoride rinses, Oxyfresh, Soni- 16 May/June 2010 JAOS
Journal of the American Orthodontic Society May-June 2010: Page 16
