1. Module 1 | Session 3 Growing your practice with communication skills
Note: This presentation can be held by the Esthetic Alliance lecturer or a Nobel Biocare sales representative.
Good Morning – Afternoon – Evening! Today we are here to discuss growing your practice through effective communication.
By sharing with you some basic facts that we have discovered regarding effective communication, our goal is to help you improve patient case acceptance.
Which in turn will lead to a more profitable practice.
Effective communication is not about mastering some tricky technique, or cornering the customer, it is about putting the patient at ease and encouraging good dialogue.
With that in mind, Tell me what are the biggest challenges your practice faces in getting patients to say yes?
Disclaimer:
Some products may not be regulatory cleared/released for sales in all markets.
Please contact the local Nobel Biocare sales office for current product assortment and availability.

2. Module 1/ Session 3: Course objectives
Growing your practice with communication skills
Effective communication with the patient
How to gain patient acceptance for dental implant treatment
Marketing your practice
Overview of Nobel Biocare’s patient education material

3. National average case acceptance rate
32%
Please adapt according to your local market situation.
What do you think the National case acceptance rate is?
This is what the research from Qube International found.
US average is 32% accepted treatment plans
US average is $2500 per treatment plan
What is yours?
100 patients at 32% = 32 accepted treatment plans
Only 80 patients at 32% = 24 accepted treatment plans
That is lost revenue of $20,000 per month
Do the math for your practice…..
But what if you could increase accepted treatment plans percent to 50%?
Even with reduced patient flow of 80, you increase your revenue from 40 patients by $20,000 !

4. Missing teeth could have a major impact on personal satisfaction
“Smile” and “Appearance of Teeth” have the largest gap between importance ratings and satisfaction levels; i.e., respondents were least satisfied with what was most important to them.
Gap
14.3
13.1
3.0
6.4
-18.7
-3.0
11.0
Please adapt according to your local market situation.
This study appears to be the largest ever consumer survey conducted regarding patients and their views on dental procedures
When patients/consumers were asked about the importance, as well as level of satisfaction they had with their smile, appearance of teeth, hair, eyes and physique;
The greatest gap between the importance, and their level of satisfaction was in the category of their smile and appearance of teeth.
If people perceive they don’t look good, either they stop going out, or they search for ways to improve.
This represents an opportunity for everyone in this room
Base: Total n = 54,680
Source: Nobel Biocare Consumer Quant Survey (N=54,680) 8/08

5. Almost half of all adults are missing teeth
Reported consumer distribution by missing tooth condition
Please adapt according to your local market situation.
Number of Missing Teeth
So what was the state of missing teeth in this survey of 54,000 plus consumers
Almost half: 48% were missing one or more teeth.
24% missing 4 or more
And 8% were missing at least one full arch
Over 60 million adults in North America are missing teeth and those who have lost 4 or more are more motivated to find a solution.
Most of these are consumers are baby boomers and they tend to self research solutions. That means that they often will use the internet as well as respond to direct to consumer advertising, including word of mouth referrals.
Source: Nobel Biocare Consumer Quant Survey (N=54,680) 8/08

6. Verbal and non-verbal messaging
7–38–55 rule
(writing)
Telephone
Face-to-Face
Words
Tone
Non-Verbals
100%
100% X
20%
80% X 7%
38%
55%
Let me ask you?
What percentage of communication do you think the “WORDS” you speak represent? How about Tone? What about Body Language?
So how much are you communicating when on a cell phone? What about and text messaging? How much tone is in either of those?
ZERO! That’s right! So how good are you at communicating with the under 30 generation that prefers text messaging?
And how good are your under 30 employees at communicating with the over 60 generation that prefers face to face communication?
Mehrabian, A. Silent messages: Implicit communication of emotions and attitudes. Belmont, CA: Wadsworth, 1981.

7. How to increase your case acceptance rate
Value = Needs Fulfilled
State:“When Patients measure their experience of us on this perceived mental value scale, there is a point at which our products and services fulfill enough of their physiological needs that they are willing to write us a check. We call this the “Yes” point, or the point at which a Patient is willing to accept your treatment recommendation.”
State: “Moving along the spectrum is the point at which the Patient’s experience of us exceeds expectations. This is the point at which the Patient leaves saying to themselves, “Wow! At this point you are way ahead of the competition!”
Ask: Who here has had a “Wow” experience when they were a consumer?
State: “This course is designed to educate you about the choices you can make in your daily work that lead to getting Patients to the “Wow!” point.”
State: “It does not have to be perfect but it does need to be better than just a yes because with a “WOW” you will get more referrals!”
Source: Nobel Institute™: Practice Communication Skills. © Nobel Biocare. 7

8. How to increase your case acceptance rate
Probability of success =
f(Content) (Process) (Form)
What
Facts
Needs
Ideas
Information
How
Words
Tonals
Non-Verbals
Media
You
Your Materials
Your Products
So what is the Probability of Success?
State: If our intention is to build long-term relationships with our patient in any interaction, how do we go about achieving that objective?
How do we talk to them? How do we ask questions? How do we influence the patient to do what we need them to do in a way that leaves them feeling that their needs are also being met?
Probability of Success =f (content)(process)(form)
Content is what you know, i.e. clinical expertise.
Process is how you convey your expertise, including communicating the treatment plan.
Form is what they see or view, from brochures and models to ambiance of your office environment.
State: Using this formula, if each of the three factors is arbitrarily valued at a maximum of 10, your maximum Probability of Success is 1000.
If you rated your practice content at 10 times your process, a 10, times form of 10 equals 1000!
Therefore if you are not batting 1000% in treatment plan acceptance then determine which of the three areas you need to work on first.
Source: NobelInstitute™: Practice Communication Skills. © Nobel Biocare.

9. Something to think about…
Being effective
is as important
as being right.
Read Slide. 9

10. Core communication skills
Three core patient interaction skills:
Gathering information: The primary information gathering skill is empathetic listening.
Organizing information: The primary information organizing skill is identifying patient needs.
Offering information: The primary information offering skill is empathetic framing.
These three skills, when applied masterfully, will maximize your probability of success in the following areas:
Building trust quickly
Connecting to the patient
Solving patient problems
Resolving patient objections
Increasing patient loyalty
Increasing patient referrals
Creating a differentiated experience for the patient
State: There are 3 core communication skills:
Empathetic listening—Gathering Information
Identifying Needs—Organizing Information
Empathetic Framing—Offering Information
Instruct:
Table leaders to start a discussion on how their practice rates in each of the areas: Area Rating (1-10)
Building trust quickly
Connecting to the Patient
Solving Patient problems
Resolving Patient objections
Increasing Patient loyalty
Increasing Patient referrals
Creating a differentiated experience for the Patient
Ask:Who had a perfect 70 total? Anyone? So you are saying there is an opportunity for improvement?

11. f trust = Building trust (credibility) * (empathy) (risk)
For the patient to say Yes we need to understand how Trust is Built:
State: The formula for trust is a function of Creditability and Empathy over the Risk of that patient taking your advice.
State: The higher the risk or expense, the more Empathetic and Creditable you have to be in the perception of the patient.
Ask: So, in your practice, assuming the risk is high which is why the National average acceptance rate is only 32%,
Where do you think you need to do some fine tuning? Is it Creditability or Empathy?
Source: Nobel Institute™: Practice Communication Skills. © Nobel Biocare.

12. Needs-oriented questions
One of the most fruitful ways to construct high-ROI questions is to focus
on where patients want to go rather than where they have been.
Needs-oriented questions
What is your vision for your smile?
What are your esthetics objectives? Your dental health objectives?
What challenges will you need to solve to achieve these objectives?
What fears do you have about finding solutions to these challenges?
What outcomes are you looking for?
How would you like to see this problem resolved?
Read the first paragraph in the slide:
Ask: How might you ask a needs-oriented question?
Ask: What questions do you ask that have been effective?
Walk through the questions and make sure you point out the difference between these open ended questions and closed questions.

13. Preparing for patient interaction
Connect with the patient
Neutralize the obstacles
Validate the feelings and concerns
Provide information that facilitates decision-making
Proactively move the patient forward
1. Understanding why the patient is there
2. Listening to the information the patient is providing
Ask: How well do you “connect” with your patients? What happens that makes you know that you have connected?
Direct participants to rank the five points on the slide on a scale from 1-5 and decide on which area they need to focus their effort to become more successful at case acceptance.
Rank 1-5
Connect with the Patient
Neutralize the obstacles
Validate the feelings and concerns
Provide information that facilitates decision-making
Proactively move the Patient forward 13

14. How not to say it
Unconsciously, many professionals choose the “spray and
pray” approach. They listen for only a short time, then they
“spray” their patient with…
Diagnosis
Treatment recommendations
Experience
Dental team
Other happy patients’ experiences
Expertise
Differentiation on second opinions
…and then “pray” that something they said will strike a
chord with the patient. For the patient, it is a short step
from there to “No.”
“Spray and Pray” is a classic and common sales mistake. Have you ever thrown spaghetti at the wall to see if it sticks so you know it is cooked? That’s the same as spray and pray!
Unfortunately, this type of approach often means little to a patient because it doesn’t address their specific needs.
It almost always comes in language the patient barely understands and is presented from the perspective of the practice. This is all about what the clinician wants to say, and very little about what the patient was hoping to hear!

15. Resolving objections Common objections:
“That sounds like a lot of money!”
“I need to bring this up with my spouse.”
“I have to think about it.”
Many dental professionals, when they hear an objection, react in much the same way our primitive ancestors reacted to the sudden appearance of a saber tooth tiger: Fight or Flight.
Between fight and flight, there is a third, more successful alternative: facilitation. Facilitation is simply applying the core skills learned in this program to better determine the needs underlying the objection. It uses the same interaction model you have been exploring.
“The major barrier to mutual interpersonal communication is our very natural tendency to judge, to evaluate, to approve (or disapprove) the statement of the other person or the other group.”
—Carl Rogers
Barriers & Gateways to Listening
Read:
“That sounds like a lot of money!”
“I need to bring this up with my spouse.”
“I have to think about it.”
Any others objections that you commonly hear? What about: “that sounds like it will really hurt!”
The “fight or flight” response to objections is another common mistake. Sometimes we fight a person’s objections if we see their argument as weak or just plain wrong. We try to educate them out of their decision or take their objection as a personal rejection. This is usually seen by the patient as invalidating their concern. It’s a short step from here to the patient no longer liking the dentists, the office or the treatment plan.
On the opposite side of the spectrum is the flight response. This can be seen as agreeing with the patient’s objection and then backing down from a higher fee or a more comprehensive treatment plan. Unfortunately, every time we utilize the flight response it gets harder for our patients and our team to see the meaning, importance and value of our services and our fee schedule. What we know about an objection to a case presentation or treatment is that an objection is equal to an unfulfilled need. Therefore the objection comes from something within the patient, some barrier they are experiencing within themselves. It’s rarely about the dental professional and more about a hope or desire the patient has that is not being satisfied by what’s presented. Asking questions about what the patient likes, doesn’t like and any factors that may be holding the patient back regarding the treatment plan should immediately follow any patient objection. Once we know the full reason why a patient is saying “no”, we have an opportunity to offer new ideas on how to address and compensate for those objections.

16. Marketing your practice
To be a successful high-end esthetic practice, you need to make patients aware of your crown-and-bridge and implant services.
State: If you are going to have a successful practice that perpetuates itself, then you need to be able to market your practice internally and externally.

17. Marketing your practice
How do patients know you offer full-mouth reconstruction and/or implant treatment solutions?
Do you have brochures in your waiting areas? Why or why not? If so, which ones? Do you conduct any external marketing activities?
Do your business cards and signage contain information about the crown-and-bridge, esthetic, and/or implant practice?
Do you have a tracking system for potential patients? Describe it.
Do you publish a newsletter that includes esthetic or implant information?
Do you schedule time to have full-mouth reconstruction and/or implant specific team meetings? Is your receptionist aware of your restorative and implant services?
Do you have a list of patients willing to talk to other patients about implants or crown-and-bridge procedures?
Do you have patient testimonials you can use in your marketing activities?
Have you discussed the best way to share information with patients?
Think about these questions: Read the slide.

18. Examples of visual aids
How to explain dental implants to your patients for your first case
20 pg educational flip chart, for individual consultations
Explains each indications with solutions
Explains why a missing tooth should not be ignored
The reverse of each page, provides support notes to the user (Dental nurse etc)
Use these aids to educate your patients and encourage them to choose the implant option
Here are the tools you need to get started 18 18

19. Patient education flip chart
Content
Introduction to implants
Facial structure
Bone loss
Treatment options
Single-tooth replacement
Several missing teeth
All missing teeth
Implant care
Improve existing teeth
Our research has shown that the more team members can talk about the benefits of treatment, the more trust and confidence they can inspire in patients, which has a direct impact on case acceptance.
The first three sections are: Why you should not ignore missing teeth, Introduction To Implants, Facial Structure and Bone Loss. We recommend EVERYONE in the office become familiar with. It doesn’t matter what role they play, front office, back office, etc. At some point, a patient will probably ask them about implants. Especially as patients begin to see more advertising and doctors begin treatment planning more often. 19 19

20. Patient education brochure
Detailed full solutions and educational brochure for patients
From single, several to all missing tooth solutions
Answers to commonly asked questions
To be given to patients considering treatment options 20 20

21. Waiting room flyer with general information about implants
Waiting room flyer with easy to understand information to read at home, or show to family members
Why missing teeth should not be ignored
Who is a candidate for an implant solution
Advantages of modern dentistry 21 21

22. Waiting room flyers – single tooth solution options
Waiting room flyer with easy to understand information to read at home or show to family members
Why one missing tooth should not be ignored
Single tooth replacement options, with or without implant
Advantages of modern dentistry 22 22

23. Waiting room flyer on missing several teeth solutions
Waiting room flyer with easy to understand information to read at home, or show to family members
Why missing several teeth should not be ignored
Missing several teeth solution options, with or without implants
Advantages of modern dentistry 23 23

24. Waiting room flyer on missing all teeth solution options
Waiting room flyer with easy to understand information to read at home, or show to family members
Explains the disadvantages of conventional dentures
Overdenture and full bridge options, both fixed on implants or removable solutions
Advantages of modern dentistry 24 24

25. Waiting room flyer – All-on-4 insert
Help dentists to communicate what an All-on-4 procedure is
Contents includes advantages, treatment candidates and photos
A loose insert for existing denture flyer 25 25

26. Waiting room posters
Posters to increase awareness and curiosity in the waiting room setting
Available as a set of three 26 26

27. All solutions posters
Educational patient poster for dentists to hang in their offices
Support dentists efforts in consultation process with patients
Help auxiliary to communicate to patients 27 27

28. Deluxe publication for patients
For the dentist waiting room area, a high quality “coffee table“ publication
Explains all esthetic solutions which use Nobel Biocare products
Book comes in a protective, hard box cover presentation 28 28

29. Relative functional capacity – upper/lower jaw situations
Nobel Biocare All-on-4
Relative functional capacity – upper/lower jaw situations
Patient situation
Chewing capacity/quality of life
All natural teeth
100%
Implant borne bridge
90%
Implant overdenture
(tissue borne)
60%
Increasing quality of life
Upper denture
30%
Lower denture
This illustrates the ‘functional capacity’ or ‘chewing ability’ of the different treatment options.
Where moving from a lower denture, to an implant retained overdenture, to a full implant retained bridge dramatically increases the function – including comfort, chewing ability and stability/retention.
[Speaker Note]: An implant-borne bridge can return the patient nearly to 100% of their natural chewing capacity
10%
No teeth, no 0%
Andries van der Bilt et.al. Braz J Oral Sci. April/June 2002 Vol 1, No. 1 29

30. Core principles of case acceptance
Your professional responsibility is to create a level playing field between doctor, staff and patient during the consultation appointment.
Patients should feel that the entire team is hearing their concerns and needs on a biological, physiological and psychological level.
The majority of patients want to feel a real connection to the doctor and office staff before they make a decision to proceed.
Patients want expertise.
Patients want to know that you are offering the absolute best solutions for them.
State: case acceptance - Implies that the Patient will leave the restorative office:
Informed
Educated
Motivated to see the Specialist for a consult if required
And in agreement to go forward with the Treatment Plan!
Read - From the slide the key desires patients want:
Patients should feel that the entire team is hearing their concerns and needs on a biological, physiological and psychological level.”
The majority of Patients want to feel a real connection to the Dentist and office staff before they make a decision to proceed.”
Patients want expertise”
Patients want to know that you are offering the absolute best solutions for them.”
How does your practice score in each area? If good then you are already achieving higher than 32% acceptance rate.
IF not then what do you need to work on first? 30

31. Marketing your practice
How do patients know you offer full-mouth reconstruction and/or implant treatment solutions?
Do you have brochures in your waiting areas? Why or why not? If so, which ones? Do you conduct any external marketing activities?
Do your business cards and signage contain information about the crown-and-bridge, esthetic, and/or implant practice?
Do you have a tracking system for potential patients? Describe it.
Do you publish a newsletter that includes esthetic or implant information?
Do you schedule time to have full-mouth reconstruction and/or implant specific team meetings? Is your receptionist aware of your restorative and implant services?
Do you have a list of patients willing to talk to other patients about implants or crown-and-bridge procedures?
Do you have patient testimonials you can use in your marketing activities?
Have you discussed the best way to share information with patients?
So, look at this list again and what on it can you work on?
Consider the suggestions we have covered in this presentation and incorporate the ones that make sense for your office.
And most importantly, to create or change a behavior, practice makes perfect.
Thank you!

32. Module 1/ Session 3: Course objectives
Growing your practice with communication skills
Effective communication with the patient
How to gain patient acceptance for dental implant treatment
Marketing your practice
Overview of Nobel Biocare’s patient education material

33. Thank you!
Let’s get going and start a booming implant practice. Here are the tools you need to get started. It’s now up to you.
Disclaimer:
Some products may not be regulatory cleared/released for sales in all markets.
Please contact the local Nobel Biocare sales office for current product assortment and availability
© Nobel Biocare Services AG, All rights reserved.