This week on A Tale of Two Hygienists TIPisode we are joined by Steve Pardue who is one of the managing members at Elevate Oral Care. This week Steve talks to us about facts to help guide your patients to improve oral health!
Continuing Education Credits
“Unfortunately only an estimated 30% of offices are dispensing”
“Over 50% of patients were at moderate or high risk for dental caries”
“Caries risk assessment is quickly becoming the standard for patients”
“The higher the risk, the more care is needed”
“1.8 ounces of a gel is only enough product to support a patient brushing twice daily for 5 to 6 weeks… that is 5 refills for 6 months of use”
“Why put roadblocks in-front of your patients, especially during a pandemic”
“Our guess for 4 brushings per day, is low compliance”
“Prices for a 6 months supply are under $14.00”
“You generate $30,000 in revenue and $17,000 in profit all while providing an ADA recommended therapy every 6 months”
Elevate Oral Care FluoriMax 5000 Products: http://www.elevateoralcare.com/products/FluoriMax5000
Elevate Oral Care Website: http://www.elevateoralcare.com
Elevate Oral Care Facebook: https://www.facebook.com/elevateoralcare
Elevate Oral Care Instagram: https://www.instagram.com/elevate_oral_care/
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This TIPisode has been transcribed for your viewing pleasure:
Michelle Strange: A Tale of Two Hygienists presents this week’s TIPisode: Quick and easy tips to keep you up to date and presented by the experts in the profession. Now, get ready for your unofficial TIPisode.
Steve Pardue: Hi, everyone. My name’s Steve Pardue, one of the managing members here at Elevate Oral Care. Do you remember Paul Harvey and his long-running radio series The Rest of the Story? If you’re too young, ask an older family member, and they’ll probably smile as they recall his iconic voice. Each story Mr. Harvey spun provided a new and often surprising fact that opened the eyes and ears of the listeners to a new mindset or a new point of view or a paradigm shift. I hope my TIPisode today provides that new, surprising fact that helps guide your patients to improved oral health.
The management team here at Elevate Oral Care has a long history of providing informative, in-office, at-home oral health prevention products. Our companies were first in stannous fluoride gels and rinses, first unit-dosed fluoride varnishes, and provided the United States’ first silver diamine fluoride therapy just to name a few.
Through the years, we’ve taught offices how to provide products for patient at-home use. Providing trusted products directly from your office provides advantages to the office and for the patient, and that we’ll discuss today.
Unfortunately, just an estimated 30 percent of offices are practicing dispensing. Why? We often hear “we don’t like to sell, and we feel more comfortable providing the patient with a prescription.” When asked if they know how that’s working for their patients and their compliance, we’re often met with a shrug.
There are many unique therapies and devices that patients don’t have access to at retail and online sources. Prescription toothpastes, gels, rinses, remineralization agents, specialty cleaning devices, interdental aids just to name a few.
Today, I’m focusing on the simplest, most common therapy with the highest compliance rate, and it’s one that can have the biggest impact on your patient’s oral health: prescription-based 5000 parts per million fluoride toothpastes.
So let’s set the table with some data. A recent, large, multi-office caries risk assessment study found that over 50 percent of patients were at moderate or high risk for dental caries. The current ADA guidelines for fluoride therapy recommends that patients with an elevated risk for caries should receive either an at-home prescription 5000 parts per million fluoride toothpaste or a 0.2% prescription fluoride rinse.
Caries risk assessment is quickly becoming the standard for patients. Were you aware the ADA recently established new CDT codes for caries risk assessments? D0601 for low-, D0602 for moderate-, and D0603 for high-risk of caries are now used by some third-party carriers to enhance patient benefits for fluoride varnish applications and for more frequent office visits. The higher the risk, the more care is needed. Consider this information for your own practice.
Data shows that if you provided a recognized caries risk assessment for your patient base, it would likely find that more than one in every two patients would be moderate to high risk and should be offered a prescription fluoride therapy to reduce their risk for caries. Many patients at high risk should also be on a three to four month recall until their risk level declines.
If only 30 percent of offices provide 5000 parts per million fluoride toothpaste for their patients by dispensing, what do the remaining 70 percent do? Well, unfortunately, many are unaware of the guidelines and don’t risk assess or provide other at-home therapies. The remainder provide a patient with a prescription for 5000 parts per million fluoride toothpastes.
Let’s explore what happens when a prescription is provided to the patient. A recent study summarized findings from a large survey of prescription toothpaste products provided from 192 pharmacies in 47 different states. The pharmacies surveyed included a mix of rural, urban, and suburban locations.
The results showed that 7 percent of pharmacies didn’t carry any 5000 parts per million fluoride toothpaste. That means the patient would have to make a second trip days later allowing time for the pharmacy to order the product from their supplier.
47 percent of the time, the pharmacy only stocked one product, a generic 5000 parts per million fluoride toothpaste, and 80 percent of the time, that generic was a gel, didn’t have any abrasives, and came in a 1.8-ounce tube. 1.8 ounces of a gel is only enough product to last a patient for five to six weeks if used twice daily. So that prescription provided by the pharmacy would have to be written up for up to five refills to provide six months of continuous, twice-daily use. That would require many trips to the pharmacy for the patient, and wait until we discuss cost of the prescription.
With patient convenience in mind and compliance already an issue, why put roadblocks in front of your patients, especially during a pandemic?
If your patients received the generic gel non-abrasive version, they were provided instructions by the pharmacist to brush with a standard abrasive toothpaste and then perform a second brushing with the prescription gel. If they’re going to do that in the morning and the night, odds are pretty low. Even if that happened, our guess that four brushings per day is going to be low compliance for that patient.
And then there’s the cost factor. 5000 parts per million fluoride toothpastes are rarely covered by prescription drug plans making it an out of pocket expense for most patients. The pharmacy study found the average cost for a six-month supply of 5000 parts per million fluoride toothpaste range from a low of $32 to as high as $160 with a mean price of roughly $60 for a 6-month supply.
As dental professionals, you have many great 5000 parts per million fluoride toothpaste options available to your practice. Most of these are brands that are not sold through pharmacies. Our advice is for you to find one. Find a company you trust with a representative who can deliver information and support for those involved in the dispensing decisions. Generally, that requires the dentist, the hygiene team, and the office staff all to interact with the patient regarding dispensing all the way through check out.
At Elevate, we’re proud of the 5000 parts per million fluoride line that we built with options of safe, meter-dosed packaging for pediatric patients and child-friendly flavors called “Just Right 5000.” We’ve got a full line for teen and adult patients called “FluoriMax 5000” with optimized abrasive levels, two great flavors, and a sensitivity option.
Both lines feature packaging sizes that will align with three- or six-month recalls, and prices for a six-month supply are under $14. So, considering the pharmacy prices that a patient would expect, dispensing a 5000 parts per million fluoride option for your patients can provide you a valuable resource of revenue all while providing your patients the convenience of a brand you trust, no extra trip to a pharmacy, and a sizable cost savings.
In the current climate of expanded personal protective equipment costs and longer patient visits, meaning less frequent patients per day, anything that can generate revenue opportunities should be explored. If an office has 2,000 patients and 1,000 of those are at high, elevated caries risks, that means there are 1,000 patients that could benefit from a 5000 parts per million fluoride toothpaste every six months. If your office can acquire a six-month supply for $14 and sell that at $30, which is a significant saving to the patient over the pharmacy prices, you generate $30,000 in revenue and $17,000 in profit all while providing an ADA-recommended therapy every six months.
As always, use the proper CDT codes for what you do. The CDT code D9630, drugs or medicaments dispensed in the office for home use, should be used for office-dispensed 5000 parts per million fluoride toothpastes. The more visibility we provide third-party carriers of this practice, the more likely they are to adopt coverage in the future.
We have a team of highly trained preventive care consultants ready to deliver safe staff meetings either in person or via GoToMeeting on an internet platform. We customize our talks to your needs and can provide valuable AGD PACE continuing education hours. This can include patient-centered communications to assist you through the process of patient engagements.
We value you as a customer, but more importantly to us, we value all the offices dispensing prevention therapies, providing patients with the treatments and brands that they trust for improved oral health. Now you know the rest of the story.
Michelle Strange: We hope you enjoyed this week’s TIPisode. Be sure to reach out to our guest experts and let them know how helpful their tips were. Follow A Tale of Two Hygienists on Facebook, Instagram, and head over to ataleoftwohygienists.com and subscribe to our newsletter. You can also email us at firstname.lastname@example.org, and keep listening for more awesome content from your unofficial dental hygiene podcast.