564 Clinical Culture *updated 2/2024*

PPE: Perfect Patient Experience

1. Phones: The 1st phone call is our 1st impressions, so let’s make it count.
a. Answer the phone with a smile in 3 rings or less. “Good morning/afternoon, thank
you for choosing Albuquerque Modern Dentists. My name is _________, how can
I help you?” Slow it down so they understand.
b. Expectation is that EVERYONE answers the phone, clinical team included. Put
them on hold or offer to have the front office call them back if needed.
2. Scheduling: WE control the flow of the day, so make it a GREAT day!
a. Following the template allows for an easy flow and starting same day treatment.
b. Get as much information (triage) from the patient as possible during the initial
phone call.
c. Explain my chart e-check- in process.
3. Pre-Reg:
a. Front office needs to be at least 2 days out at all times.
b. We will maintain a pre-reg score of 90%
4. Confirmation Calls:
a. 2 days out: Get verbal confirmation and explain my-chart e-check-in process (or
thank them for doing it). Remind them to bring in the medical and dental
insurance cards.
b. 1 day out if they have not confirmed. Get verbal confirmation and explain my-
chart e-check-in process (or thank them for doing it). Remind them to bring in the
medical and dental insurance cards.
5. Reconciliation:
a. Reconcile all outside information.
b. Check for xrays being due.
c. Change the health maintenance for the appropriate frequency.
6. Check-in process:
a. Welcome everyone with a warm smile.
b. Thank for completing the e-check in or help get them checked on the i-pad
c. Scan Medical card and dental card
d. Sign all consents and F/As
e. Offer to take payment now or at end of appointment.
f. New Patients/Specialty: give gift bag CCX: give toothbrush. Both include google
information.
g. Write on careslip
i. What is being done today?
ii. Is the CCX scheduled?
iii. Have they paid? If not how much to collect?
h. Bring careslip to the back and alert back office team that a patient s waiting.
7. Meet and Greet:
a. Doctor to greet every new patient (if time allows) for the interview in the consult
room or exam room. During interview, discover the 4 chiefs. Dr to bring patient to
exam room or x-ray room to hand off to dental assistant with introduction. If not
assistant will greet in lobby, introduce self with a smile and escort to x-ray room.
i. Ex: Welcome to our office Ms. Smith. What brings you in to see us? How
long has that been bothering you? Was there any thing preventing you
from taking care of it sooner?
b. DA handoff:
i. Reiterate patient’s CC and prescribe radiographs.
1. Take CBCT 1st
2. Take 2D radiographs
ii. Protocol:
1. NP/Full exam: FMX, CBCT, intra oral photos
2. Limited/Emergency: BWX(posterior), PA, CBCT, intra oral photo
iii. Ex: Ms. Smith, his is our assistant Bruxir, She will be helping us to get
some x-rays and photos to help us see what is causing your pain in that
tooth. Lily, Ms Smith is worried about sharp lingering pain on her lower
right when she bites or drinks something cold. Can you get a BWX, PA,
CBCT and a picture of that tooth please?
8. Pre- Charting.
i. Chart existing and start formulating a treatment plan.
ii. Let HC know you are ready to chart
9. Examination/ACC/T dialogue (HC or DA in room to chart)
a. Following the eamination present the disease findings, consequences of the
findings and then pause. Utilize the ACC/T dialogue with same day urgency
b. 1:1:1 plus Ortho
10. HC handoff: Transfer of Trust
a. Dr introduces HC to patient ( HC moves into a comfortable line of site for the
patient.)
b. Dr reviews the treatment with HC and patient
c. HC thanks Dr and asks any questions.
d. HC presents cost with patient. Keep it simple and remember the power of the
pause.
e. Get needed consent and sign FA
f. Write on Careslip what we are doing, and alert DAs
g. If it is a no, get Dr to come back in for a reverse handoff.
11. Same day treatment:
a. DAs set up room to be ready to go when Dr is.
b. Teamwork, Dr helps numb for hygiene and vice versa.
c. Front office: offer tour of the office, beverages, blanket etc.
d. Be clear about timing. If we need to kill time, let front know.
12. Check out process:
 a. Receive careslip from DA/ clinical team
b. Verbally review what next appointment is
c. Ask how visit went
d. Check for CCX appt made
e. Collect payment (if haven’t already)
f. Ask for a google review
g. Offer to print AVS
Protocols:
Hygiene:
Indications for prophylactic cleaning, oral hygiene instruction and fluoride varnish
1. No recession, attachment loss or bone loss
2. 1-3 mm perio pocket depth with less than 30% bleeding, light or no plaque
Indications for gingival scale:
1. Recession, localized mild attachment loss 4 mm max, no bone loss, light to
moderate supra ginigival cal. No subging
2. 1-4 mm perio pocket depth with more than 30% bleeding, moderate plaque, no
subging cal
3. 4 mo pre re-eval. SRP/gum tx discussed if condition is not improving.
4. Alert 2 added to every FA
Indications for SRP:
1. Clinical attachment loss, 4+ or more, bleeding upon probing, recession,
subgingival calc, furcation involvement
2. 4+mm perio pocket depth with more than 30% bleeding, sub-gingival calc,
moderate supra-gingival calc.
MPP added to 1st PMV after SRP,
Perio consult scheduled 3 months after PMV ( periodontitis with 6 mm probing depth,
radiographic vertical bone loss or greater than 30% horizontal, not stable ppd with
bleeding, recession 2-3 mm, furcation involvement.
Perio referral for non-hygiene:
a. Restorations violating 2mm of biological width- decay equal or subcrestal to
periodontium
b. Complicated/esthetic implants
c. Gingivectomy
d. Esthetic crown lengthening
e. Gingival recession.
Fluoride: offered with every prophy, ging scale PMV and SRP unless otherwise specified
Velscope: offered annually with exams
Bacterial Decontamination:
a. Inflammation of the free gingical margin
b. Offered with all SRP and ging scale
c. High risk IL-6 with oral DNA upon PMV
Indirect Restorations (CEREC/Crowns/Inlays/Onlays)
a. Cuspal involvement, involvement of ≥ ½ occlusal table, failed direct restoration
involving more than ½ the occlusal table, existing restoration with marginal or groove
fracture, open contact progressing periofontal disease, anterior tooth decay or chip
with esthetic converns, failed existing indirect restoration, root canal treated postier
teeth, radiographic decay within 1 mm of the pulp.
b. Relevant details of execution:
a. CEREC on every tooth other than anterior esthetics and implants
b. CEREC should be delivered same day, exceptions would be going to endo,
needing Bruxir, time allowances.
Endo:
Indications:
a. Radiographic decay or failed restorations within 1 mm from the pulp, tooth has severe
sensitivity or pain
b. Fracture with sensitivity to cold and bite
c. Existing RCT with inadequate fill needing an indirect restoration
d. Xray/CBCT revealing PA abscess
OS:
Indications:
a. Patient under age 30 with impacted 3rd molars
b. Patient over age 30 with PBI 3rd molars with 4+ mm PPD or gross decay
c. Patient over age 30 with erupted 3rd with gross decay or gross plaque, and not able to
clean hygienically.
d. Terminal dentition due to gross decay or poor perio prognosis.
e. Damage to adjacent teeth due to gross decay from poor hygiene
Relevant Details:
a. All 3rds molars to be presented with IV sedation
b. All single unit extraction are done with socket preservation bone graft and membrane
c. Biopsies to be referred to outside oral surgeon
d. All full mouth extraction should be done with IV sedation
 e. All acute situational anxiety patients should be offered IV sedation.
Tooth Replacement:
Implants:
a. All non-third molar teeth that have opposing occlusion, all dentures for fixed or
removable support, high risk cavities patients.
Fixed Bridge:
a. Partially edentulous arch with good prognosis adjacent teeth with no possibility of
implants due to ridge or affordability, failing existing bridge, low cavity risk and good
OH
Removable parital or full denture:
a. Partial or full edentulous arch with no possibility of ridge augmentation and implant
placement, unable to afford implant dentistry, edentulous space with guarded to poor
prognosis adjacent teeth.
b. Full lower denture should be planned with 2 implants minimum for bone preservation,
retention and resistance
c. Partials: always offer metal if distal extension and pt likes to eat or esthetic area premium
material (Valplast)
a. Always make stayplate for esthetic area that needs ext or implant. It is for the
interm not for long term.
d. Full dentures:
1. Immediate denture impression
2. Extractions/ Ridge augmentation/ alveoplasty
3. Discuss implants
4. Reline lab hard
5. Final denture plan for 6 weeks after surgery
Ortho:
a. Aged 7+ for consultations due to crowding, diastemas causing food traps,
esthetics, TMD, up righting FPD abutment teeth, malocclusion (class II or III and
cross bite), collapsed centric bite.

Financing:
1. Always use Ollie (FMP). Hand patient keyboard or iPad to fill out thoroughly.
2. Care Credit, SGF are preferred
3. Smart pay must be approved by OM and require 2 credit cards on file
4. Smartpay above $1500 need to be approved by OM
5. Past due report is to be worked weekly, by all member of the front office team
6. We do not leave accounts unsecured
 7. Unsecured report to remain below 8% and worked daily

Morning Huddles Mandatory:

a. Review Daily XP/ Weekly notifications
b. Review schedule for today and tomorrow
c. What went well yesterday?
d. What could have been better ?
e. Review spec schedules
f. Review updates on my office page
Compliance
a. All training and modules to be done in timely fashion
b. Past due compliance modules= no bonus for anyone
c. Lad prep work ad budget supply worksheet due 25th of the month
d. Facility review, safety committee, safety meeting due 15th of the month
e. Inventory turned in the 7th of the month
f. Maintenance tasks divided among team members.
Workqueues:
a. Pre-Reg at least 2 days out always
b. Specialty prepped 1 week out (schedules sent 1 week, and 2 days)
c. WQs cleared by Friday.
d. Strive for efficiency always.
Smart Scheduling:
a. We want productive schedules for all our providers.
b. All treatment not started today requires a deposit to hold their spot (includes specialty)
c. At least 1 hour of every day is devoted to treatment follow-up/ missed CCX report.
d. Hygiene needs 4 Q of SRP every day.
e. Communication, communication, communication!!! Let our patients know what is going
on. Offer, coffee, water, get up and walk around or watch a movie up front etc.
f. Ensure quality referral for all specialty appts.