Dentaltown August 2016 - (Page 30)

pediatric dentistry message board Continued from p. 26 than one sedation visit, the parents would not choose a conscious sedation simply based on the cost. I do not practice in an area where I could routinely charge $400 for a sedation. I am now considering having different fees for sedations. If it is a routine case, or if I am recommending a sedation, then we will charge the typical fee. If a patient is very challenging to treat, or I feel that a sedation is likely to fail, we can still give it a try, but at a higher fee. ■ 5/11/2016 KatyDoc Member Since: 11/02/12 Post: 14 of 26 I see this trend getting worse. (Maybe it's because I'm in Texas.) I have parents who now refuse even nitrous. They don't want "any type of sedation whatsoever." I have a feeling this mindset will only continue to get worse. ■ 5/11/2016 drifter57 Member Since: 12/08/09 Post: 15 of 26 Hmm, I have to ask my staff for the form. Parents are going to get upset either way. But when it fails, it drives home the need for treatment for GA, and it pays for your time to set up and drop the drink down the hatch. Sometimes the other option goes where it's likely a visit under IV/GA is better, but I suggest we can try with nitrous first. Then I will credit their account toward an IV sedation, because I suggested it, not the parent. Semantics, but it gets the point across. These are lost kids and families in the first place. To convince them otherwise is an uphill battle. But if they want to try against your recommendations, you should get paid for "trying," right? ■ 5/11/2016 Kiddent Member Since: 04/28/05 Post: 16 of 26 I will "try" even when I know it will fail. Yes, it's a dead appointment but some parents need to see that to move forward. I call these a code smear with my staff. When placing topical I shield the child from the parent and I smear globs of topical all over the tongue and lips so the child goes crazy. Then I tell the parent if they won't tolerate a little topical then no way the other treatment will happen. ■ 5/11/2016 Tooth Whisperer Member Since: 06/11/07 Post: 18 and 20 of 26 Well, crap, I just referred a family of four to you who are moving just outside Raleigh! I forget sometimes some of you guys don't do OCS. If the only options are GA versus nitrous, that seems even more clear-cut. If a kid is likely needing GA, no way nitrous is going to do a thing. Trying nitrous is pretty innocuous. I have one Medicaid plan here that gives us trouble all the time. We treatment plan a kid who is hiding under the chair but is 6+ years old and they come back and tell us we have to do OCS. Nope. I'm not giving a kid sedation meds when I have zero confidence it's going to work. ■ 5/11/2016 pedoburrito Member Since: 02/08/09 Post: 21 of 26 If code smear does not work, you can always add on a code for "madly wave needle in the air." We humor parents with failed nitrous appointments as well. One thing that has worked for me is that I will ask the parent to talk to their child while I give them a few minutes alone. Gives me a chance to check hygiene, drink coffee, see a man about a dog, surf internet, etc. When I return and the child hasn't magically transformed into a cooperative patient, the parents now have ownership over the problem. Often their frustrations have shifted from us to their child so we're no longer the bad guys who failed at the appointment. No one offers OCS in my area so it's either nitrous, OR, or papoose. I'd guess 90 percent of parents will schedule the OR visit after the failed nitrous appointment. Around 5 percent will find a mill to papoose their kid and the other 5 percent will wait until things abscess before returning to schedule an OR appointment. ■ 5/11/2016 28 AUGUST 2016 // dentaltown.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown August 2016

On Dentaltown.com
Howard Speaks: You Don't Know COGS
Professional Courtesy: The Promise of Technology
Continuing Education Update
Industry News
Dealing with Parents Who Refuse GA Whose Children Obviously Need It
Class II Composite Technique
Best Alginate, Hands Down!
The Pillars of Attraction
Out-of-Pocket Collections: Mending the Holes
Dentists Playing Bankers: A new perspective on accounts receivable
Character Studies: Your financial tendencies likely depend on which of these nine archetypes fits you best
Quality Control: Five reasons you should purchase quality hygiene instruments
Practice Solutions: 3M
Opting Into—Or Out of—Typical Transitions
Treatment of Intraoral Infections
Service Profile: Gilleard Dental Marketing
Product Profile: Ivoclar Vivadent
Immediate Implants: Tips for improving the outcome in the aesthetic zone
New Products
You Should Know: Call Sumo
10 Strategic Insights for Patient-Producing Postcards
Monthly Poll: Pediatric Dentistry
CE: Oral Diseases Associated with Men
Dentally Incorrect

Dentaltown August 2016