During economic uncertainty, patient comfort is king.

A soft economy brings fresh challenges to conducting a dental practice. Patients often postpone elective procedures--and sometimes even nonelective ones. Corporations are less likely to fund dental insurance. Businesses that do offer dental insurance may institute hiring freezes or downsizing, leaving more people potentially under-insured. And if that isn't enough, depressed local job markets can prompt people to leave communities altogether in search of employment.

But even when the indicators all look bleak, it's important to maintain perspective. People need dentistry. It's important to their health, their well-being and their self-esteem. In times of economic trouble, dental practices can continue to thrive. The key is to remember the basics. For dental assistants, that means making sure that patients are secure and comfortable.

Our Rochester, NY, dental practice in many ways typifies classic general dentistry. Our patients include office workers from the city's nearby business district and families who have made their homes in our neighborhood; they span the entire economic spectrum. We treat senior citizens and preschoolers. Many of our older patients have been coming to this office since the practice was first established here, 45 years ago.

We do see fluctuations in the practice during times of economic uncertainty. When patients start to worry, our appointments drop off. Patients wait longer between hygiene visits.

But we always weather the bad times, because we retain a respectable base of loyal patients. We do this by making customer service our highest priority. We look for ways to make patients feel comfortable with their surroundings, their treatment and their financial options.

Office Ambiance 

We start with office ambiance. We have an advantage in this regard: our practice is located on the first floor of a 19th century mansion, This gives our offices a homey look. When you walk in the front door it is like entering someone's home. The walls have tiger oak wainscoting and mahogany trim. Instead of sterile, stark furnishings, we've chosen home-style furniture for our decor. Paintings hang on the walls.

Like many dental offices, we also offer ways to keep patients occupied during their appointments if they wish. We have televisions in our operatories, so patients can watch educational or relaxing videos.

We also try to reduce stress by not falling behind on appointments. We know that patients today often schedule their days tightly. If their dental appointment starts late, it can throw the rest of the patient's day off. So we make every attempt to see people within five minutes of their scheduled appointment time. Of course, sometimes we can't avoid slipping further behind. If this happens, we try to phone the patient before he or she has left for the appointment. We then offer to reschedule the appointment.

Patients appreciate this for two reasons. First, they are glad that we respect their busy schedules enough to warn them that we're falling behind. In addition, when we do fall behind, it's usually because another patient has come in with a dental emergency. Patients whose appointments are moved often say they don't mind, because they know we'd do the same thing if they needed urgent dental care.

Finally, we watch for patients' special needs. Senior citizens, for example, may not be able to lay back as far in the dental chair. We make sure they know we can accommodate them to make sure they're comfortable.

We also encourage new parents to bring their preschoolers along when they come in for hygienist cleanings. When a two-year-old child has watched his morn or dad in a dental chair, the child's first visit won't be as frightening. We also often use these first visits as an opportunity to gently introduce the child to dentistry. We may, for example, paint some delicious-tasting toothpaste on the child's teeth.

Since families are a significant part of our practice, paying attention to toddlers' comfort is an important part of maintaining good patient relationships.

Treatment

Pain management is, of course, another important way to keep patients comfortable. Before any procedure--whether or not it's one that requires local anesthesia--we always ask our patients to let us know if there's any discomfort.

We often use topical anesthesia for hygiene cleanings as an extra measure to ensure comfort.

Once a procedure has begun, we periodically ask whether the patient feels any pain. We also watch the patient's body language. Sometimes patients are reluctant to admit they're in pain. So we take the initiative if there is any suspicion that something hurts.

While most of our pain management is targeted at hygiene and dental procedures, we have also taken steps to eliminate discomfort during x-rays. Some patients dislike the sensation of x-ray film packets in their mouths, so we now use Kodak SureSoft Intraoral Dental X-ray Packets. These packets have a cushioned edge, making them more comfortable on patients' mouths and helping eliminate patient concerns that their x-ray packets will hurt. This is particularly helpful for patients with small mouths, including children and teenagers, or patients who have trouble opening their mouths for some reason. The packets are handled and processed just like regular x-ray film. And because SureSoft is packaged with Kodak InSight Intraoral Dental Film, this film also lets us keep our radiation doses low.

Finally, we spend time explaining to patients what we are going to do before we start. If a patient is in for a filling, we go through the procedure in advance so the patient knows what to expect. We do the same before we begin taking x-rays.

And any time a patient seems anxious, we ask about it. Sometimes, all it takes is a caring question to help a patient relax.

Finances

Another source of stress when patients visit their dentists is financial. We try to be sensitive to people's financial situations. If someone has questions about health insurance, we do our best to help. If a patient doesn't have dental insurance and can't afford a procedure, we offer alternative ways to pay. For example, we have a relationship with a company that offers a revolving line of credit to pay for dental care. With this sort of plan, patients can get small loans that are often interest-free for up to 12 months.

No matter what the economic climate, people will continue to seek dental care. By being sensitive to patient comfort, a practice can lower patient stress, build loyalty and encourage word-of-mouth referrals. Customer service, in dentistry as in all businesses, is a fundamental. And at no time are fundamentals more important than during times of economic uncertainty.

(Note: Kodak and SureSoft are trademarks.)

Richard V. Romano, DDS, is a 1980 graduate of Hobart College and a 1984 graduate of NYU College of Dentistry. Karen Warner, CDA, has worked with Dr. Romano for eight years Dr. Romano and Ms. Warner practice in Rochester, New York.