The ability to create some day crowns in the office has many advantages for both the practice and our patients. Many of these we are all aware of: convenience, marketing, no lab bill, just to name a few. One of my favorite things to do with the CEREC system is to turn the emergency fractured tooth into a beautiful all ceramic crown in the same day. Emergency patients do not have to be a source of stress if you have systems in place and a well-trained team to execute. In fact, they can be a great source of added production and can be converted into raving fans.

An emergency patient phones your office and states that they “broke a piece of tooth somewhere in the back”. No pain. How does your staff handle this? Many offices will have the patient come in when it is convenient for the practice for a “look-see”. An administrative team member without much clinical training often handles this call. This staff person will sound annoyed and inconvenienced. I love this approach. You have your patient leave work mid-day just to determine they need a crown and then have them come back after you smooth their sharp area. It’s time to start treating these patients as opportunities for the practice. It just takes training.

How about this approach? At the morning huddle determine where in the schedule you may be able to handle a CEREC crown. Discuss any emergency phone messages. If someone breaks a tooth, it’s time to do some homework before returning his or her call. If this same sort of patient phones during the day, the same wheels go into motion. Here is our protocol.

1. Find out where the tooth is located. Upper, lower, left or right? How many teeth from the back? Any pain? Etc. Now that your admin team member has gathered the necessary info, ask permission to call the patient right back after they “consult with the Doctor”. Hand the case over to a treatment coordinator (assistant).
2. Pull up digital radiographs and images of the patient’s tooth/area in question. You should be imaging each tooth as part of your new patient comprehensive exams.
3. Check the clinical notes. Was a previous recommendation made for this tooth?
4. Discuss with the Doctor as to whether or not this patient is potentially in need of a crown.
5. Research the patient’s insurance to accurately determine any out-of-pocket expenses.
6. Now call the patient to schedule. “Mrs. Patient. The Doctor has looked at all of your x-rays and images and it looks like you may need a crown on that tooth. If it needs a crown, we will be able to take care of it today and your co-pay will be $____ . How about 1 o’clock?”

Now you have a captive audience. The patient was upset enough that she broke her tooth and she is motivated and grateful to have it taken care of that very day. No big discussions needed chairside as most of their questions have already been answered. No insurance/financial song and dance while they are in the chair. Most importantly, no chance of blowing off their crown appointment after you have smoothed the tooth at the “look-see” visit. 

Of course there is always a chance that they made not need a crown after all. You can turn this into a celebration as your patient was prepared for the worst. You are now a hero. Did you lose production? No. They weren’t actually treatment planned and scheduled in the first place. If you take this approach and gamble and win a few times each month, it can certainly have a positive impact on your bottom line.