Dr. Lee Sheldon, a Florida Periodontist, discusses the future of dentistry post - COVID-19, emergency patients, needed vs wanted dentistry, and more.
Liz Lundry, RDH - “Hi, everyone. I'm Liz Lundry, the clinical education manager for StellaLife, and I want to thank you for joining me today so that we can have words of wisdom from Dr. Lee Sheldon, who is joining and presenting here on our Innovators series. So Dr. Sheldon is a periodontist and maintains a small group practice in Melbourne, Florida. He and his office manager, Danyel Salmella, who is also going to be joining us today, quickly build the practice from a referral practice, to a direct to patient practice, providing both periodontal and restorative services in their office. Their new paradigm of periodontal services has become a topic of interest among periodontist. Over the past few years, they have spoken to both national and regional periodontal societies across the US, their founders of the mentoring group, the Institute for Dental Specialists, and have co-authored two books for the profession. They were early adopters and are strong supporters of StellaLife, and we want to welcome them both. And I'll go ahead and let Dr. Sheldon take it away. Thank you so much.”
Dr. Lee Sheldon - “Thanks Liz. We've got some problems we've got to overcome right now, you know? We got to look at the tools that we have to put in for the future. And now is the time to visit those tools, to understand what it is that we need to do while we're down in order to be able to move things up. So, Danielle, we've already started doing emergency dentistry, let's talk a little bit about that and how that's going. And that's only this week, so we're still finding our way around that, too. So what have we found?”
Danyel Salmella - “Well, I think that initially, our goal was to provide comfort to our patients that couldn't come in and find a way to kind of keep their thought process of "this is just going to be a little bit of a delay and then we're going to get started." So that was our first goal was to give that comfort to our patients. And then the next thing was, "Okay, what are some things that we can do with our staff to keep things going, thinking, of course, that time it's only going to be a few weeks and we'll do this." So I think that we have done all the necessary steps along the way, because then we got to a point where we're like, "okay, we can only clean so many baseboards and stock so many drawers and do that. Okay, now what can we do?" So we kind of came to that point where all we have left to do is create something. Okay, so we don't normally see emergencies, we refer emergencies out if something happens. But now we are that person. So now we're taking on our own emergencies or taking on new patient emergencies and we're kind of opening our door to a new avenue that we're not really used to doing, but it's keeping us busy, it's keeping us doing what it is that we're doing. It's also allowing us to realize that maybe there's an untapped market that we haven't really explored yet, which is how in the past, Dr. Sheldon, we've come to these new levels of discovering an avenue that we've never done before. So it is kind of bringing us to new normals that we didn't know and as we have talked in many of our other webinars in the last few weeks is trying to figure out that, you know?Trying to figure out what more could we do? What different could we do? And maybe those "mores" or "differents" are things that patients who haven't come in yet, have been waiting for. Maybe it is the online consult because they just don't want to leave their house or they can't really leave their house, or maybe it's just more convenient for them. So it's "What can we do now with these emergencies?" is a first for us of "okay, this is working. It's not what we had before, but it's working," and we're seeing some lights with this opening up to emergencies."
Dr. Lee Sheldon - “I think we're also productive at least, we're not making a lot of money, don't get me wrong, but at least we're doing something. We're doing something that we know how to do. Now, understand those of you who know that were periodontists, we're direct-to-patient periodontal practice with a restorative dentist. Frankly, it becomes easier for us because a number of the patients who came in for these big procedures started off with an emergency. They just had been without dentistry for 10-15 years and are finally saying, "Alright, I got to do something. All right, finally, this tooth is too loose, or I've got a toothache. I'm going to go see them." And this may be the way for the future. That's the way that we've been saying anyway, as specialists, we have to go directly-to-patient. We just have to go directly-to-patient. This may be your opportunity to go directly-to-patient. We're better suited. Most of us are better suited in order to be able to to help patients and help them out of the emergency and once you help them out of the emergencies, then you can move farther. Now, I know it's not all specialists on this program. In fact, that's probably more general dentist than specialist, but understand that we have to move the patient through the continuum and the way most people start as an emergency, so it's not so bad. I think the worst thing we can do right now is to sit back and say, "Well, the governor won't let me practice," and "okay, if it is an emergency, I'll refer it out to the oral surgeon I'll refer it out to-" No! Get the patient used to coming into you. And of course, we've already put a notification on our website. We see emergencies. We got a light inside. We see emergencies, and we're seeing emergencies. Some of them are ours, yeah, and some of them are on the outside. It is a way of getting your practice in motion. We're talking about getting the entire economy in motion? Well, you've got to get your practice in motion, too. And now is the time to do it, in emergencies is one way. What about the needed and wanted dentist rate? I think that's a good topic as well Danyel, people walk in and we think they need everything. When we're doing cosmetic imaging, and they need to have the pretty smile, and they need to have the root coverage procedures that we do as periodontists, and they need to have the implants. There's a difference between needed and wanted and it's not what we feel is needed or wanted, it's what they feel, what the patient feels is needed and wanted.”
Danyel Salmella - “Well, the funny thing is, we spend a lot of our time, we spend a lot of our time before with these patients trying to convince them of the dentistry that they need, and anybody out there who has been present in a treatment presentation knows it's not easy. You have to convince them of, "hey, it's okay to invest in yourself." You should be investing in yourself. This is not going to get any better, this is going to get worse. Look at what you're doing now, look at what you could be doing. Look at these success stories, and it's not easy to sell dentistry. And it's funny now that we can't do it, they're asking for it. So how many patients have you had to say, "I want to have teeth. I want to get these teeth. I wanna have these implants. I want to have this prosthetic," and we have to say, "well, we can't do that." And it's so funny that now they're wanting us to do it. And we have to say, well, not right now. So it's kind of like it has changed because they can't have it, they really, really want it now. But with these emergencies that we're seeing, I have had at least two patients say, right when you open up your door is, "I want to get started on this full arch prosthetic because I'm so tired of this breaking dentistry of parts and pieces and here and there and I fill in a pull and a partial, I'm done. I want to have it." So I think it's also bringing people to the mind of "I gotta keep on this stuff. If something like this happens again and I haven't taken care of myself, these things start happening." People don't want to go to a dentist right now, they don't want to go to the doctor's office right now, they don't want to go to the grocery store right now, they want to stay home. They're realizing that they have to keep taking care of themselves so that things like this don't happen.”
Dr. Lee Sheldon - “We have to look also at diagnosis. We've got to concentrate on diagnosis first. We're very much doers, we're very much treaters. Okay. We're periodontists. There are diagnostic entities that we have whether we're talking about using a microscope, whether we're talking about using the oral DNA test or something similar in order to be able to help a person save teeth, we're very much into extracting teeth and replacing them with dental implants. the pendulum swung in that direction. We can now swing back in the direction of saving teeth and saving teeth appropriately using some of the diagnostic tests. Use your periodontist if necessary, in order to be able to determine what bacteria is growing there. What antibiotic might help with that bacteria as well as good, deep, thorough root planning. We use the Periscope, which allows somebody for a much lower cost than extracting the teeth and even putting in dentures to be able to save the teeth. So you're going to be saving the patient money because the patient is going to be a little bit reluctant to spend money right now. Just one of those jobs, many of them for four, six, eight weeks or even longer. So let's look at what we can do at a lower cost in order to be able to give our patients results. From a restorative standpoint? Yeah. Are they all going to be crowns? No. Can we do for-service composite? Yeah. There are things that we can do in order to be able to keep patients happy, keep patients coming in and provide a very valuable service to them without necessarily making them spend more money than they're prepared to spend right now. They will spend it later on. So what is your for-service composite now, is your build up at the crown later on. And we've got to just look in that direction. Danyel and I've been talking about a reset button ever since we started this three weeks ago. All right, give me your examples, I'll give you my examples, but you give me your examples first of reset. What's the reset button for you?”
Danyel Salmella - “Well, to me, the biggest thing is, you kind of touched on a little bit, I think we've all done this personally and professionally. We're kind of sitting back. We were kind of sit back in the beginning, going, "well, there's nothing we can do. We can do nothing. We just have to sit back and wait," and you have to realize that this situation of the whole world stopping is never going to happen again. So we really need to look at it as an advantage to reset and think about what you really want. What structures do you really want in your practice? What kind of a team do you really want? What kind of organizational kind of schedule? What is it that you really want that you have been thinking every day going home like, "I wish my practical like this," well, this is your time to do it. You can go through staff and you can get rid of the ones that just drive you crazy because really, you're probably not going to need that full staff, right? When you get started, just go with the ones that are die hard, dedicated and hard workers. Reorganized, restructures, implement some organization, some communication and those of you that our members or anybody who comes over, we have a whole portal of modules, of how to answer the phone, how to communicate, how to organize, how to have staff meetings, and so many of the people that want those are on there going, "okay, now I can sit here and go through all these things, and we can have these meetings on Zoom with my team still, and we can do some training and we can do some cleaning out." There's so much you can do to reset your practice so that when your doors are open again, you have all this stuff in play, or at least a nice agenda of how we're going to be doing things because this ability to reset, to sit back and think of what we really want and change those things, it's never going to happen again, because you're to be busy again with your schedule, busy again with your families, and you're going to be putting those things to the side again. So to me, this is really an opportunity to think about all those things and if you can't actively do that right now, at least take the notes and at least get that thought process going and what you want to change when you start back again.”
Dr. Lee Sheldon - “I can't add much more to that, except go to directorofdentistry.com if want to see some of the things that we offer, but the principle here is we're not just waiting to go back. We're proactive right now. We're pushing that reset button in order to be able to get leaner as Danyel said, we're deciding what services we can expand, how we can provide services that are going to be at a lower cost but valuable to the patient, we have that, we're going to be in real good shape coming out of this.”
Danyel Salmella - “Yes.”
Liz Lundry, RDH - “Thank you so much. Dr. Sheldon and Danyel. What a wonderful approach to take us back to the future, thank you again. So thank you all for joining us today. Please come back next week and we're going to be featuring another wonderful innovator. Dr. Steve Roser is going to be joining us, and that will be at twelve noon, Pacific Time, 03:00 p.m. Eastern. Looking forward to seeing you then. Have a wonderful week.”