How Dentistry Will Change in 2021





By Lexi Marino January 19, 2021

In this episode, we caught up with Melissa Turner, RDHEP, BASDH, EFDA to discuss how dentistry is rapidly changing with new advances in technology and methodologies of care.

Watch this video to learn the following:

  • The rise of women in the dental profession
  • Mobile dentistry took off in 2020. What’s next for this type of care?
  • How generational shifts will change dentistry from patient based to consumer based

Rolando Mia, from Zyris, is the host of our series, Dental Voice. In this show, we focus on the latest news, topics, and conversations happening in dentistry and assess differing views across the nation. In Season 2, we’re focused on, “What’s Working and What’s Not”, where we’re debunked myths by assessing trial and error since the start of Covid-19.

Transcription:

Rolando Mia: Good day, everybody. Welcome to Dental Voice, season two with Zyris. Our guest is Melissa Turner, RDHEP, BASDH, EFDA. She is a dental hygienist and holds a master’s degree.

Good day, Melissa. How are you?

Melissa Turner: Hello Rolando. Thank you for everybody watching. It is amazing to be here.

Rolando Mia: One of the things that I’ve noticed about what you’ve done and what you’re doing is kind of there’s an incredible energy around providing dental access and then care. If you could kind of share with us, what’s driving all of the things that you’re doing. If you look, you worked with the Dental Peeps Network, you launched iHeart Mobile Dentistry. You’re also a Chief Hygiene Officer, co-founder of the first Annual National Mobile Conference, American Mobile Teledentistry Alliance. I mean, what’s driving that? Take us through that.

Making Dentistry Better for the Provider

Melissa Turner: You know what, I’m just having fun. Isn’t that like what we’re all supposed to do in our career is have fun and it took me a while to get here but I’m having fun. The bottom line though, Rolando and thanks. You know, thanks for asking because I honestly don’t get that question a whole lot. And so to be able to like, just lay it all out and share my heart is exactly what I want to do and what I want people to ask me the why. Why am I doing these things? And very rarely does it happen.

So the bottom line is I want to make dentistry better for not only the patient, but for the provider, right? Because if the provider is thriving, if the provider, you know, is really living a full and complete life and mental health is great and, you know, everything is just, you know, fulfilling, then we can communicate that much more with our patient. The patient has a better chance at success in achieving health. You know, it just goes round and round like that. And so everything I do, whether it’s mobile dentistry, teledentistry, whether it’s consulting, whether it’s just being an advocate for underserved individuals, everything I do is to help create a better environment for a patient and provider.

Rolando Mia: And that’s kind of… It sounds like that’s the energy that’s driving it. Because, I mean, COVID 19 literally whacked us up the side of the head beginning of this year. It and has caused anxiety, fear, and lack of information. Throw that into the mix now, the underserved care access to care, not only do you have patients who are afraid to do that, you’ve got clinicians, dentist, hygienists, dental assistants who are afraid. How does this kind of fit into that and what is it that you’re doing to, you know, help people understand that it’s okay?

Better Access to Oral Care for All

Melissa Turner: Well, and one thing, one thing when I talk about underserved individuals within dentistry, it’s not just indigent communities. It’s not just, you know, the rural out-state populations. It’s not just those that don’t have autonomy. If we really take a look around, we know dentistry as a silo. We know dentistry is hard to access and it’s a difficult industry to be in but also for patients to receive care from.

So when we think about underserved individuals, it’s really our cousins, our parents. You know, it’s everyone because it’s a fortunate thing for someone to be able to receive regular access to dental care. And so, especially now in a COVID environment, you know, we were set down for months and now we’re on that six-month cycle where we’re starting to see that dip in in patients again. And it’s just, you know, we’re at a point where we can connect dental professionals, dental practice owners.

We all went through the same shared experience that our patients went through, the same COVID 19 hell, right? We all went through it. And so it’s a way, right? And we’re all trying to recover. It’s a way that we can connect with the patients and really help care for them because we’re all trying to recover from it and figure out what the new normal is. And some of us are trying to hold onto that old normal in the past.

Rolando Mia: From a provider perspective, let’s start from there. What would you say are like the most important things that they need to remember, and they need to ensure that they’re doing now?

Rebuilding Trust with Our Patients

Melissa Turner: Yeah, right now it’s all about rebuilding that trust with the patient. It’s all about rebuilding that trust with each other on the clinical team. And it’s also all about rebuilding trust within yourself too, I got this. I can go into the future. We can make this dental practice successful. We can treat our patients even though you might feel unsafe, even though we’re in hazmat suits and all that kind of PPE. So right now it’s rebuilding that trust and that comes through communication.

I’ve learned this in my marriage. I’ve learned this in these partnerships that I’ve had, it’s all about communication. And so if we can create touch points with patients to further that communication, so whether it’s virtually reaching them in the palm of their hand, or whether it’s initiating care and bringing that oral care and oral services to their house and delivering it to them.

I mean, those are two main ways that we can say, “Hey patient, we care for you. We’re going to go out of our way, and instead of expecting you to come through our doors and the fixed dental practice, we’re going to come to you and help make you feel safe.” And when we communicate this with them, this is the key to really coming back and recovering from COVID-19 shutdown and everything that came with that.

Rolando Mia: Wow, it’s interesting. I’d love to kind of dig a little further. When you say rebuilding the trust, what happened? In your opinion, what happened? I mean, going to the dentist is not something people normally want to do. You know, there’s a stigma associated with it. But now, what do you mean trust? What happened from your perspective?

Melissa Turner: Yeah, well, so there’s two ways to look at it. And the first one is the acute trust that was lost during COVID-19. So dentistry, you know, it’s top of the news for saying it’s the most unsafe career to be in. You know, dentistry was shut down because it was unsafe to be in the dental practice during COVID-19. And so there’s that kind of acute short-term trust that was kind of lost between the patient and provider. However, we’ve had decades worth of distrust. Like you just talked about Rolando, decades where we’re transparency with patients wasn’t happening. Patients would walk in and not know if they have to pay anything for that appointment today. And like, we can rebuild trust that way.

We can begin to say, “Hey patient, we got you.” Like, this is a conversation, this is a dialogue. We’re going to help make your mouth healthy. We’re going to help make your whole body healthy. And just because we’re wearing a white coat and we’re professionals doesn’t mean that you have to be scared of it. We can bring back that empathy and active listening and all that kind of thing, in the patient relationship that’s almost been lost in the last decade or two, I would say.

Rolando Mia: So the trust is not necessarily in the clinical from a clinical perspective. It sounds like it’s reassuring people that this is part of systemic health. That you need to understand how this fits in because we’ve kind of lost that. Do you think there’s fear, if I were to say fear and I’m talking, you mentioned both the patient and the provider? Do you think there’s fear there that’s kind of driving some of the behaviors that we’re seeing today?

Melissa Turner: Oh, of course. So the first thing that happens when I tell even my friends, when I first meet them, they ask, “Oh, so what do you do for a job?” And I say, “Oh, I’m in dentistry, I’m a dental hygienist.” And the first thing they do is kind of go like this and look away, “Oh, don’t look at my teeth.” They’re so, you know, even we experienced this too. I’m like, okay, I haven’t bleached in a while. Really, don’t look at my teeth.

So that in itself produces fear because the teeth are right in front of us. You can’t hide it. You know, you can’t hide it from anyone you’re talking to. And so I think fear comes a lot from being unsure if people who smile are beautiful, if they feel like their smile is beautiful. And that’s, I think a lot of the disconnect in dentistry. We take it for granted because we are knee deep in people’s mouths all day long. I spent most of my entire adult life smelling other people’s breath and I don’t want to. Like analyzing tongues and I don’t want to. My adult life is like dedicated to this. And so it’s normal for us to look at somebody’s mouth and be like, “Hey, you’re fine, like everything’s great.” But for people, it’s a vulnerability really. When a patient comes to us, it’s vulnerability.

Rolando Mia: Wow, I love the context around you. You’re so right.

Teledentistry Is Redefining Dentistry

Let’s talk about technology and teledentistry. How does that fit into this, kind of the whole reassuring, communicating? How does it fit into overcoming the fear of seeing your dentist?

Melissa Turner: Yeah. You know, Rolando, it’s interesting. It’s interesting because it’s so multifaceted, it’s depending on who you’re talking to, right? Like the answer to that is depending on who you’re talking to, what patient you’re talking about. I think the gist is there’s a couple things that are happening right now in dentistry and they are redefining this industry.

So we’ve got the technology like you were talking about, the teledentistry and other clinical technologies, that are really moving at the speed of light or sound, just moving faster than we can imagine. And to think that, you know, a single technology could drastically change dentistry. I mean, that’s where we’re at. A technology could come out tomorrow where it already has a teledentistry and it can change the entire face of dentistry once we understand how to use it.

So then we also have, we have a shift in our patients. We have a generational shift that’s happening right now. We have the millennials, reclaiming the rise of the workforce and becoming the leaders and also becoming the patient majorities. And so what that means is millennials are expecting technology to be integral in dentistry. They’re expecting us to come to them through their phone and deliver care, right?

Then on top of that, we have an industry now where more female dentists are graduating in dental school than males. And so not only do we have the shutdown that has changed dentistry, but we also have technology that’s ever-changing dentistry. We have the millennials that are coming up and now we have kind of a gender shift within dentistry. And whether we want these things to happen or not, it’s going to completely redefine dentistry as we know it over the next five years. And that’s kind of… I’m really excited about dentistry because it’s going to give us a chance to start over. I’m always a fan of starting over and being able to change for the better. I don’t even know if that answered your question, but yeah.

Mobile Dentistry

Rolando Mia: Basically tell me if I got this. Dentistry is evolving. There’s so much change that we have to stay on top and we have to embrace it because if we don’t, we’re going to basically kind of get left behind.

Melissa Turner: That’s right.

Rolando Mia: Now, let me ask you this. You mentioned the whole idea of serving and gaining access to the population and then also you mentioned that our generation, the boomers are transitioning. What are the three biggest things that will come from these changes?

Melissa Turner: Yeah, the three biggest things I would imagine are how we deliver care. So that comes with teledentistry and mobile dentistry. And if we take a step back and really look at those two things in particular, teledentistry is really the most modern form of mobile delivery, right? Neither the provider nor the patient needs to be in the dental practice. They could both be in their own beds or on the beach or whatever for that encounter to take place, right?

So that’s going to be completely transitional because that leads to the second thing that’s going to really usher in the future and that’s a change in the provider mindset. And I kind of alluded to this before. But instead of being in a small dental practice with fixed walls, and instead of being in a small up and expecting the patients to come to us. I think there’s going to be a mindset change within dental professionals and practice owners and within dentistry as a whole, where we no longer sit and wait for our patients to come through our front doors, right?

I mean, imagine the decrease in no-show rates, if you can take the service to the patient. I remember practice owners just like crossing their fingers and holding their breath, waiting for that next patient to come through the door. What if you don’t have to do that anymore? What if you could just take it, take it right to the patient?

Millennial Mindset of Care

I think the millennials are starting to expect to be treated as consumers and not necessarily patients. And so I think we’ll see an increase in branding. You know like my generation, we love Starbucks, right? We like going to Starbucks and we can anticipate the same thing and consistency at any Starbucks we go to. And so I think that’s my idea, so as are starting to take off in this consolidation of dental practices, but I think we’ll see an increase or shift in how we brand and how we market our services to the patients. We’re seeing that we’re seeing that already, we are.

Rolando Mia: Wow, actually what kind of blew my mind is this the context of bringing the dentistry to the patient, because as a patient, you’re on your way in, and you get distracted and you’re like, “Oh, well, I’m not going.”

So, with mobile dentistry you’re breaking down the walls around that. That’s interesting. How’d you come up with that?

Melissa Turner: I didn’t come up with it. There are use cases around the country that are proving this delivery and improving it successfully. And the cool thing is it’s, it can be like, once you tear down the fixed brick and mortar walls of your practice, like in your mindset, then I say this all the time and it’s so cheesy, but the opportunities are endless, right?

So over the COVID-19 shutdown, for instance, these practices who had already started delivering their care, you know, they didn’t have to shut down quite as much because you know, they could go to the patient instead of the patient, like being scared and fearful and having to come to the dental practice.

Mobile Dentistry and Large Organizations

We’re seeing a lot of these large mobile organizations that would take care into workplaces like Nike headquarters or Amazon. We saw them pivot now to take care into patients’ homes. And it’s kind of a different business model. You know, it’s great for residential towers because everyone’s there already.

We also have successful mobile practices who literally take concierge services, you know, to everyone’s houses. And once in a while, they’ll stop at a community center and some folks will meet them there. And you know, those were the patients they have for the half a day. But this model has already been proven so it’s nothing new. It’s just, what is new now is our patients are asking for us to do this. And even before the shutdown, our patients were asking us to deliver things to them. Let me think how many times we ordered from Amazon or order our groceries, or I can even get my library books delivered here in Portland sometimes.

Sometimes we just need to say, “Hey dentistry, like get your butt in gear.” Like this is, we are fluid. We have to adapt and meet the needs of who we are serving and it’s time to really get our butt into gear especially after the shutdown. So that’s my message. If you remember anything from this conversion, get your butt in gear.

Rolando Mia: It’s interesting, we’ve had several guests on. One very recently, Dr. Mark Liechtung and he mentioned hygiene is the engine, is kind of the thing that really drives the practice. Because in hygiene, that’s the initial engagement. Do you agree with that? Do you see it as the kind of the front end of the whole thing?

Hygiene is the Future Face of Dentistry

Melissa Turner: I mean, Rolando, I might be a little bit biased because I’m a hygienist, but absolutely I do. So here’s what’s been happening for the last couple of years now. Every, probably every week, I have a new conversation with a company, whether inside or outside of dentistry, industry leaders or folks wanting to bring innovative things into dentistry and the first thing they say to me is “Melissa, we know dental hygienists are the face for the future of dentistry.”

We know that preventive measures are now being incentivized. Instead of just treating disease and getting incentivized for that, we’re seeing in healthcare now that prevention is starting to be incentivized. So, it’s only going to be a little bit of time before that really comes to dentistry. And so who’s the prevention focused person on the dental team? It’s the hygienist. So obviously yes, hygienists are going to play a huge role in the future.

And you know, I’ll be quite honest and say that I’ve had this conversation with a lot of practice owners and sometimes they get a little scared when they hear that. The truth is if hygienists can succeed, then the dental practice will succeed as well. And if a dental practice owner can do all they can to empower their hygienist, then they will see a change in their practice, you know? And it’s one of these things, it’s happening. And it’s just a matter of, “Okay, are you going to jump on board or not? Are you going to start to really empower the hygienist?”

So we talk about move of dentistry. If a dental practice can send a hygienist out into the field even just one day a week or two hygienists out into the one day a week, think about how much chair time, like clinical surgical chair time that that would open up for the dental practice. So then they can have more patients come in and do more lucrative procedures, do the complex, all the procedures that they didn’t have time for in the beginning.

They can even bring in traveling specialists and house all the referrals under one roof which is an entirely different dialogue, an entirely different conversation. But it’s a win-win for the dental team and it’s a win-win for the practice owner and for the hygienist. So that’s why I’m so passionate about this. It’s like, dude, we’ve got to get on board. Like, this is where we’re going, let’s just get on board.

Rolando Mia: Let’s do it, all right. So now, all right, I’m going to hit you here.

I love the sentiment behind that, and I love it. And in the practices where you see a phenomenal relationship between the hygienist and the dentist and there’s a meeting of the minds and an engagement, it’s wonderful. What we’re hearing is there’s friction between the hygienist and the dentist, and it’s on both sides. And by that, I mean, you’ve got dentists who feel everything is my way or the highway. And then you’ve got hygienists who are coming back with a sense of entitlement. How do you bridge that gap?

Bridging the Gap Between Hygienists and Dentists

Melissa Turner: Are you sure you want my thoughts on that? It comes down to really what kind of conscious biases we’re holding on to in the dental practice. And again, this is an entirely different conversation because when a dentist graduates from dental school, when a hygienist graduates from hygiene school, we’re already almost indoctrinated into the antiquated ways of thinking, you know. And then to go into a small team environment, it even kind of amplifies the biases that we might have, that we don’t even know we have, right?

So a significant part of my experience as a clinical hygienist has been living and working all around the States. So, you know, after I graduated at hygiene school, I spent the next decade kind of following my partner’s journey around the States, his educational journey and his career journey. And so every year or two, we would be living in a different state.

And really Rolando, within the first six years of clinical practice, I already had four different state licenses. And so it was insane, and it got to a point where, it wasn’t even worth me going on an interview to get a permanent position because the practice owner would look at my resume and be like, “you’re not anywhere for more than three years. Why would I want you to come on my team, right? So what I started doing was temping as much as I could and for full-time, right?

So to this day, I have lived and worked in hundreds of dental practices all across the States. And what that taught me was that this dynamic is rampant. This friction between the dentist and the hygienist is rampant, and it’s something that needs to be healed. And the only way you can do that is to dive into yourself and figure out why am I having these biases and then communicate. So like over the shutdown, we saw a lot of, well, no, we saw very little communication between the practice owners and their team.

It wasn’t just practice owners and hygienists, it was practice owners and their team because nobody had answers. Nobody knew what PPE to use for a while. Nobody knew when they were going to come back to the practice. And so that caused extra friction on, you know, these relationships that were already, you know, kind of built on trauma and distrust. And so, yeah, it’s heavy.

Like when I think about this and a lot of times, traditionally in the past, you know, a dentist works for a solo practice for his whole life. A hygienist works for the same practice for her whole life and now we’re not seeing that anymore. So we’re starting to understand that, okay, the problems that this dental practice has is the same thing that this dental practice has. And we’re starting to understand that this is a much larger issue than we even thought. So, that’s sad.

Rolando Mia: What I got out of that is this, it’s real. So folks, it’s real. The practices that are getting along are not everybody. So first thing you got to do is acknowledge it’s real because in order to address or overcome issues, you got to address and I love the message which is figure out what your biases are, figure out what it is that’s causing you to do this and then communicate. And you brought it all back to communicating which is pretty cool.

Bringing Empathy into Your Team’s Communication

Melissa Turner: It’s never been a better time to, I mean, we’ve all been through the same shared experience as I said earlier. Like we’ve all been through the COVID-19 shutdown and so we can all relate and empathize with each other now. So, it’s a great time to start that communication.

Rolando Mia: That’s cool, yeah. What better than now? And I love it. So you do a whole bunch of different things. If I understand correctly, you have a partner in crime that you do stuff with. What’s that all about?

Melissa Turner: So my very good friend, you might know her as the geriatric tooth fairy. But Ms. Sonia Dunbar, she is a TEDx speaker, she is a hygienist. She is a powerhouse and an inspiration. She is the diversity representative for Crest Oral-B. And so you’ll see her around speaking on that. So she and I have teamed up in the last year to really begin to proclaim the message of mobile dentistry of teledentistry and about what it means for the future of dentistry.

And she and I have always said, 2020 is going to be a big year for mobile and teledentistry. We didn’t know how big of a year because when it shut down, even it accelerated it. I mean, you search teledentistry and Google trends and you see the spike, this isn’t just a vertical spike right around the mid-March when everything’s shut down.

So she and I, we launched the first National Mobile Teledentistry Conference back right before the shutdown, and probably the last conference to even be held. You know, we came home right then, everything started shutting down and that was an amazing conference. It was to bring together, you know, it was kind of like a family reunion. We were happy if we could get a hundred people in the room and it sold out and it sold out again, we had to find more space.

And so what we realized from that is that this is in more demand than we even thought. And so our next conference is coming up March 4th through 6th, and it will be in-person and it will be virtual, it will be hybrid. And so that’s really fun and amazing and get ready, we will be social distancing and masked up but we’re still going to have fun.

Rolando Mia: Okay, very good. First of all, that’s awesome. If you were to take everything we’ve been talking about here and kind of wrap it up as a message that you’d like to get out to our community, to our patients, to clinicians and their teams, what would that be?

Dentistry is Changing Whether We Like it or Not

Melissa Turner: Well Rolando, I think the message would be this. Dentistry is changing whether we like it or not and it’s changing in a significant way. And it’s changing because of what we’ve been through as providers, it’s changing because of our patients are changing, generations, our society has changed. I mean, so it’s kind of this is the bottom line. You’re either on board and help control the change and help use it to your advantage or you don’t and then you might have to struggle. So there’s this theory out there, there’s this stoic philosopher that says in any situation, there’s three components. Any situation has things that you can change, that you have control over, things you cannot have control over and things that you can impact.

Rolando Mia: Well, so thank you so much for doing this. Really appreciate it. It’s been an absolute pleasure.

Melissa Turner: Love it, thank you, Rolando. Thank you, Zyris.