Perfect match

Collaboration between numerous specialties is raising the care provided by dental surgeries to a whole new level.
Collaboration between numerous specialties is raising the care provided by dental surgeries to a whole new level.

Your practice can’t offer every single service under the sun, so how do you develop and maintain effective relationships with various specialists that can add value to your practice? Natasha Shaw find out

Are you aware that more and more dentists are taking the next step in customer service by offering peripheral care for their clients? For example, someone might visit a dentist for a tooth extraction, while being overseen by a psychologist to get over a phobia of going to the dentist. Or a person may suffer from facial pain so a dentist will refer them to a temporomandibular joint (TMJ) physiotherapist.

Collaboration between numerous specialties is raising the care provided by dental surgeries to a whole new level; it’s all about being able to offer clients a complete service for their particular ailments. After all, many dental matters are quite complex and may stem from underlying problems unrelated to what you just see inside a mouth, such as teeth grinding that is caused by sleep disordered breathing.

Dr Anthony Au of Dental Specialists Turramurra in Sydney likens himself to a ‘master builder’ in his surgery and admits that about 80 per cent of his clients would need outside care in conjunction with his treatment. “Because dental problems can be complex, I’m like the manager of a building project and have to get other contractors in to help,” he says. “A lot of the time a patient’s jaw problem is linked to their neck, spine and shoulders so often they need treatment further down and it’s not appropriate for me to go there. That’s when I might need to refer to a TMJ physiotherapist or musculoskeletal physician.

As patients are often seeing two specialists at once, and sometimes multiple, the coordination of their care can get tricky. “Coordinating between various specialists can be difficult. I often can’t start my treatment until someone else is finished, so if I’m not, or my staff are not, on top of it, then patients can be left by the wayside,” explains Dr Au. “Also, professionals who are technically skilful can be booked up quite far ahead. We have a database of who we have referred the patient to and our staff constantly check it to see how patients are going with other people.”

iStock_000023115405_Full_PPIt takes two professionals to tango

Dr Narinder Singh is an ear, nose and throat (ENT) surgeon who specialises in rhinology and snoring/OSA (obstructive sleep apnoea). He is the head of the ENT Department at Sydney’s Westmead Hospital and runs his own practice, Ear, Nose & Throat Sydney. About half of his referrals come from dentists, including general dental, cosmetic, orthodontic and maxillofacial practitioners.

“Building a trusted relationship with an experienced and proactive ENT colleague, with a special interest in the airway, is critical to the success of all dental practices, particularly those with paediatric and snoring/OSA patients,” says Dr Singh. “Undertaking interceptive maxillary and dental interventions without first addressing the nasal airway may result in poor outcomes and patient dissatisfaction. Most paediatric dental patients are referred to me for the combination of blocked nose, mouth breathing and snoring (leading to underdevelopment of the maxilla), and malocclusion.”

Collaboration tends to work best when you are dealing with good communicators and both parties are happy to work in a team approach. This way the patient is provided with added value because they are managed by specialists and get special overall care.

“For us, every patient referral involves close collaboration,” says Dr Singh. “We work with our dental colleagues to ensure a clear nasal airway prior to the majority of interceptive dental and maxillary interventions. Also, whenever a Mandibular Advancement Device is being considered for snoring/OSA, it is only created in the setting of a complete treatment plan.”

Similarly, psychologist Gemille Cribb of Equilibrium Psychology in Sydney’s CBD feels that close collaboration with a dentist over a person’s treatment is important. “We can work independently, if needed, but collaboration via phone call or email is preferred. The dentists find it helpful to know what to expect from a patient and the techniques that the patient has been taught to use during their dental procedure,” she says.

In the treatment of a person experiencing a phobia of going to the dentist, Cribb says it is very beneficial to collaborate with the dental practice so the patient can engage in graded exposure which will help them overcome their phobia.

“Graded exposure involves the patient exposing themselves to stimuli that cause anxiety. We construct a hierarchy and generally start with the stimulus that is the most tolerated, such as watching videos of dental work, being in the waiting room of the dental practice, looking at dental instruments, etc, and work up towards the stimulus that causes the most anxiety such as watching a needle being given, getting a needle, etc,” she explains. “Cooperation with the dental practice allows the patient to move more quickly through their phobia as they have better access to the stimuli and situations that are on their hierarchy.”

Industry talks and workshops are a great way  to meet professional specialists.
Industry talks and workshops are a great way
to meet professional specialists.
Building relationships

Establishing close working relationships with specialists can be a little like dating—you win some, you lose some— but in the end you hope to find lasting happiness.

From an endodontist to a periodontist or a musculoskeletal physician to a psychologist, just how and where do you meet them? Industry talks and workshops are a good start—Dr Singh met some of his dental colleagues while being the guest ENT speaker at dental airway/snoring/OSA courses and conferences around the country.

Dr Au has been working with many of his preferred specialists for 10 to 15 years now and says he met them through a combination of word of mouth, recommendations from other people who used them and networking with other dentists. But what if you are just starting out?

“If somebody is a new dentist working at someone else’s practice and they need to refer, they would probably ask their boss for a name. The other way people meet specialists is during their undergrad training,” says Dr Au.

“There are specialists who come in to teach and the undergraduate might remember one or two of their teachers. The best way to begin a relationship with them is to give them a call and ask, ‘Can you help?’ and see what they say. You could also take a case to them and ask, ‘Is this the type of work you do?’.

“These days a lot of specialists are also very active on Facebook,” adds Dr Au, “so some of the younger colleagues would refer patients to those specialists that parade their victories there. Their page might look impressive and so a dentist will decide to give them a go.”

And why not? If dating is heading online, why shouldn’t dentists take advantage of this forum too? Here’s to finding your perfect professional match!

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