What Edentulous Patients Want: How to ensure your patients get the best full-arch solution for them

Treating an edentulous patient with a full-arch restoration is unique in that it can be an emotional journey for not only your patient, but also for you! 

If the last time you delivered a denture was during dental school, you might feel a mix of excitement, nervousness, maybe even trepidation, as it calls on many of your clinical skills to ensure a good outcome. 

If you’re a seasoned clinician and already offering implant-retained dentures (a.k.a. overdentures) and you’re ready to start offering LOCATOR FIXED^® in your practice, then this post will help you improve your case presentation to get more case acceptances.

For your patient, becoming edentulous is a major life event - maybe they were expecting it, or maybe they weren’t. In either scenario, many patients can be uncomfortable talking openly about losing their teeth because they might feel shame, embarrassment, or even fear. 

So regardless of your own emotions about treating with overdentures or fixed dentures, your patients are looking to you for comfort and reassurance that you’ll help restore their smile - and their confidence, too.

How you approach each case and the way you communicate with each patient who’s experiencing edentulism has a powerful impact on the patient’s whole experience in your practice. Your approach also plays a big part in what type of prosthesis they choose to go with.

Have you ever felt a little nervous presenting a high cost treatment plan to a patient? 

Human emotions, like empathy, naturally come into play when you’re talking about treatment options.

Even though as clinicians we try not to, as humans, we might assume things about patients that we don’t know to actually be true. We might inadvertantly downplay more costly treatment and give subtle signals that a lower cost treatment is just as good, simply because we have an unspoken bias. 

Have you ever presented treatment like this? 

“Mr. Smith, we could do an implant-retained denture if you want, or we can just do a regular denture and see how you like it.” 

Notice how that sends a message that the denture is a perfectly good option and the implant-retained denture is a luxury. 

We know for a fact that an implant-retained denture is a better option for a patient’s overall health, but the unspoken assumption is that the patient can’t or won’t want to go through with an implant-retained denture.

What if you presented like this?

“Mr. Smith, I recommend an implant-retained denture. Dental implants will preserve your jawbone for longer and also give you the ability to eat the foods you want.”

What separates a good clinician from a great clinician is the ability to communicate well. The clinicians with the most case acceptances have honed the skill of patient communication. They’re able to set the patient’s expectations during the planning phases so that the patient can make an informed choice. Communication from the start also ensures patients aren’t surprised by the changes they’re about to experience, rather, they’re prepared for what to expect after having all of their teeth removed.

Great clinicians also excel at presenting all treatment options and allowing the patient to feel in control of their own healthcare decisions. After a decade of presenting treatment to patients myself, I zeroed in on the conversational steps that actually worked to gain patients’ trust and ultimately helped them choose the recommended treatment. 

Just for fun, I have a handy acronym to help remember each communication step - because the order of these steps is important! Remember this acronym: LAYERS. 

LAYERS stands for Listen. Acknowledge. Yes. Exam/Educate. Recommend. Step away. 

You can easily incorporate LAYERS into your patient communication for better fixed and removable prosthesis case acceptance:

First and foremost, listen to your patient’s chief concern. Before an exam and diagnostic information is discussed, it’s essential to really hear and strive to understand their chief concern. 

You might think they want a fixed prosthesis to chew the foods they like, but they might want a fixed denture so they can go out to dinner with friends and not worry that their teeth will fall out when they laugh!

This is your chance to have any accidental assumptions about a patient set straight. 

Ask your patient, “What is most important to you?” You might be suprised by their answer and it will instantly steer your conversation in the direction of the solution that’s right for that specific patient.

Your patient needs to feel that you hear and understand them. Acknowledge their feelings with empathy, even if you don’t think you’d have the same feelings if you were in their situation. 

Show acknowledgement and empathy by using active listening skills like making eye contact and avoiding being distracted. Nod your head to show you understand them when they’re talking. 

Use re-affirming phrases.

“It sounds like it’s been hard to enjoy social gatherings because of your teeth, I’m sorry you’ve been going through that.”

This is important. After your patient has explained their chief concern, repeat back to them in your own words what you think you heard. Ask them if you understood correctly. 

You want them to say yes to you. 

That might sound something like, “I’m hearing that what’s most important to you is feeling confident in social settings. Do I have that right?”

Once the patient agrees that you understand them, you’ve gone a long way in gaining their trust and it also helps ease any nerves they might have. Now you two are on the same page and they’re ready to hear what you have to say.

Now that you’ve gained trust from your patient, you’ll do your exam. Once your exam is complete and you have the diagnostic information you need, educate them succinctly in layman terms about what’s going on in their mouth and how it correlates to their overall health. 

Express any concerns you have. 

Ask your patient if they have any questions about what you just explained. 

At this point, if you’ve been genuine in the previous steps, then a patient’s next question for you will often be, “So, what do we do?” They’ve given you a perfect segue into your next step.

It’s time to present your patient with treatment options. Let them know that you’re going to provide more than one option for them. You’re going to start with what you recommend based on their chief concern and what you’ve found during your exam.  

Repeat their chief concern as you make your recommendation so they’re reminded that you’re keeping it in mind. 

Always start with the very best, most comprehensive treatment plan. Pause and let them respond to this plan.

“Mr. Smith, based on what I see on your x-rays and given how important it is that you feel confident to eat and laugh at social events, I recommend a fixed denture. A fixed denture is securely attached to dental implants so that it can’t be removed - it feels the most like natural teeth compared to other types of dentures. There won’t be a risk of your denture falling out and I like the fact that it will help preserve your jawbone for much longer.”

Hand them a patient education model to look at and give them a few moments to think about the first option. After any questions are answered, offer them their second and third, maybe even fourth option.

The last option, by the way, is to do nothing. Doing nothing is always an option! When giving this option, also inform the patient about the consequences of doing nothing. This shows that you’re confident in the best treatment option, but you’re not pushing them to do anything they’re not ready for. 

Recommending treatment in this order should also ease any nerves you might have about presenting a high cost treatment plan, because you know you’re also going to give them the zero cost option. 

Never, never, never downplay the best clinical treatment option because you think it might be too expensive for the patient because you truly do not know.

Once you’ve given the options, ask the patient if they have any questions for you. If they do, then answer them. If they don’t, then let them know you’re going to give them a few minutes to see if anything comes to mind and meanwhile you’ll ask your treatment coordinator to put together the treatment plans and go over different ways patients typically choose to finance their treatment. 

Smile, thank them for choosing your practice, then step away and let your patient decide.

It’s easy to speak confidently and be encouraging when everything looks healthy - but how do you talk to a patient whose mouth isn’t healthy? How do you deliver a less than desirable diagnosis? How do you talk to a patient who is about to lose all of their teeth?

Patients experiencing edentulism need us to advocate, educate, support, and encourage them just as much as patients with healthy teeth and gums.

Your support staff plays a critical role in patient education, case presentation, and case acceptance.

Empower your staff to know the important details of the types of treatment you offer so they’re equipped to support you. For full-arch solutions like removable overdentures (or “snap-on” dentures) and non-removable LOCATOR FIXED dentures, lean on your support team from Zest Dental Solutions. 

Zest Dental Solutions prides itself on having a team of representatives who are both in the field and available via phone, so wherever you are in the United States, you have support. It’s important to us that we help ensure your cases are successful.

Contact our customer support to be put in touch with a clinical representative in your area. We can’t wait to work with you!

If you haven’t already, get educated with us! We have a growing community of Zest Masters and so much support online and in person. Visit us online and learn about all we have to offer in continuing education. Check out our education calendar here and choose from a variety of online and in-person continuing education!