Talking to patients about fluoride varnish

ONE SENTENCE SUMMARY

How to talk to patients about fluoride varnish

BEST CASE SCENARIO IF WE ARE 100% CONFIDENT

Patients get the care they want, and don't feel pressured to do things they don't care about.

WORST CASE SCENARIO IF SOME OF US ARE NOT

Patients feel like we are pushing fluoride on them as a money grab. They get upset that they weren't told what was happening or how much it costs. They feel like we are taking advantage of them.

WHAT DOES 100% CONFIDENT MEAN?

You can roleplay these scenarios with 100% confidence.

HOW IT WORKS:

1. Who is a candidate?

2. How do we bring it up?

3. How to handle typical patient responses

Step 1 - Who is a candidate?

Anyone with moderate or high caries risk.

For example:

• multiple crowns and veneers

• heavily restored

• active decay

• poor oral hygiene

Step 2 - How do we bring it up?

"Because you have ________ (active cavities, lots of old fillings, lots of new crowns, etc), I'm worried that you are at risk of getting future cavities. One of the best ways to reduce your risk of future cavities is to apply fluoride to your teeth. I can paint on a layer of protective flouride onto your teeth and it soaks into your teeth to make them more resistant to cavities, and then I can repeat this whenever you come back to get your teeth cleaned. Does that sound like a good idea to you?

Great! The cost to do that is $____ - are you ok with that?"

***You MUST discuss the cost with the patient. If you don't, many of them assume that it is free or covered by their insurance just like the rest of their visit.

Step 3 - How to handle typical patient responses

Does my insurance cover it?

"I'm not sure. Most insurance companies do cover it, but I can't tell you for sure. Worst case scenario it costs you $____, and what we are trying to do is prevent cavities which can cost hundreds or thousands of dollars to fix. Are you ok with that?"

Can you check my insurance for me?

"I'll give you the code and you can either call your insurance company or go online and check. Let's leave it for now, you check your insurance, and then we'll talk about it again next time."

No thanks

"No problem!"

*** We are not in the business of trying to convince people to do something they don't want, or to care about something they don't. If they don't care, then neither do we. This is definitely an area where we don't want to push patients. We made a suggestion. They can either take it or leave it. No big deal. Remember: No judgment, no lectures, and no hassles.

No thanks - and please stop asking me about it

"No problem! It's just a suggestion, and if you're not interested then we'll leave it alone. In the future, we might bring it up again if we see a need and to check if anything's changed. If you're not interested, all you have to do is say so and we're all good!"

***We can NOT promise that we will never talk about fluoride again... because we might. It's like asking your doctor to stop telling you about your high BP. It's their job to tell you. If you don't care, then just nod politely and move on. There's no need to be rude about it.