Inside Dentistry
June 2008
Volume 4, Issue 6

What Life Insurance and Nightguards Have in Common—A Practice Perspective

Gary M. DeWood, DDS, MS

I need some better patients. Mine just don’t seem to get it. They tell me that health is important to them and they state very clearly that they want to keep their teeth. They always check that little box on the health history form that asks about it. I’ve gone back over so many of these with my team and we all agree that’s what they said. I’m not the only one who hears it. When these people come to our practice their teeth are important to them, they want to come every 6 months. They want to be healthy and stay that way. Then, even though they say that their oral health is important, they listen politely to my recommendations and either decline to act at all or go home to “think about it.” What do they need to think about?

I have worked very hard to learn to see all the things that might get in the way of them being optimally healthy. I spend thousands every year on continuing education so that our team stays on the cutting edge of dentistry. We have invested heavily in the latest diagnostic equipment. We create detailed treatment plans that are used to produce stunning case presentations, fully explained with animations and actual pictures of each patient’s teeth designed by expensive educational software. The team has worked hard with me. They appreciate the need to listen, to use appropriate verbal skills, to offer options in financing the required care, to employ the systems that we have developed together so that all patients are offered the very best we have to offer. We are good.

In spite of all our efforts we continue to be confounded by the number of patients who say one thing and do another. What’s the disconnect?


When Cheryl and I finished our residencies and entered private practice we were approached by a friend who asked if his brother could spend some time with us some evening. After discovering that he had recently taken a position with a major insurance company and we were not scheduling an Amway session, we agreed. He asked us some questions and proceeded to give us information about the benefits of life insurance. We didn’t have any. These were the days before personal computers so our guest only had the benefit of a notebook that he could turn into a three-sided “presentation board.” I remember lots of graphs, arrows, and depictions of what could happen if we failed to act. I also remember thinking “no thank you.” At this point in my life I was young, immortal, and already had a list of things that I wanted to spend my money on. I promised to “think about it.” I didn’t.

About 18 months later my eldest daughter was born. If you are parent, go back to the first night in the house without one of your parents or in-laws there and grab that feeling again. I must have checked on her a hundred times to make sure she was still breathing. I came face-to-face with the reality that I was responsible for this person. I owned the need to act on that responsibility. I did.  I called our friend and asked his brother’s name because I couldn’t remember it. He was still in the business and, “yes, I’d be happy to come visit you again.” He brought the notebook that he turned into a three-sided presentation board and showed us a lot of information, and this time that information made perfect sense. He was talking about me! I told him how much better this was than the “stuff” he had brought last time. He thanked me and looked puzzled. I couldn’t wait to get signed up.

What was different? I learned later that the “stuff” he brought was the same. Before, rather than act, I needed to think about it. I didn’t, until I owned a reason to act rather than “think.”

As I thought back on this experience years later I realized that I had spent a large portion of my career offering life insurance to people who didn’t know they needed it. Everything that I had said to my friend’s brother told him I wanted life insurance. Every recommendation he made was absolutely in my best interest. Maybe I don’t need better patients. Maybe I need to move beyond information and find something patients can experience, a feeling that moves them to action. It is NOT about information. If it was, they would all buy life insurance.


Occlusion and occlusal disease are sort of like life. Everyone knows about what can happen with it and almost everyone thinks it happens to someone else. What if we could find a way to let people experience something that would give them a basis for applying it to themselves? What if we could bring them face-to-face with the reality that they need what we have? What if we could do this gently, through discovery that the patient could make within a process? Would you be willing to try it? I bet you already have, at least partially.

We were blessed in my practice with many people who recognized a need for a nightguard. These same individuals often denied the presence of occlusal issues in their mouth. I struggled with that disconnect until I had my epiphany with my new daughter. Perhaps the nightguard could bring them to an epiphany of their own. Making that happen would require a shift in my thinking from product to process, from the nightguard as a unit installed to the nightguard as occlusal experience created through the process of wearing it. Did it work? Yes…and no. When it did not, however, the patient was left with a finely tuned orthotic that continued to carry the potential epiphany within its design, an epiphany that we could ask about at 6-month intervals. When it did, I didn’t have to flip many pictures on my three-sided notebook presentation board before they signed up.

The necessary requirement in this is time. It takes time to adjust the orthotic until it is a precision instrument. It takes time to ask questions about what the patient is experiencing. It takes time for some people to realize they need life insurance and ask for it. I want to be there when they do. Time implies a need to be paid. Unless you are practicing dentistry for purely philanthropic reasons, by choice, compensation is a requirement of the activity.

I know what you’re thinking. “So what does this orthotic look like?” “How do I make this orthotic?” “How do I charge appropriately for this orthotic?” Or perhaps, “I’m already doing everything you’re talking about!” If any of those thoughts are in your mind, congratulations! This article is not about fabricating the orthotic appliance. I would love to work with you on the skills, techniques, and systems implicit in each of the first three “thinkings.” The design of the orthotic will depend on an evaluation of cranio-mandibular health, your occlusal philosophy (yes, I have mine) on the type of “appliance” you or your technician prefer, and the occlusal issue questions you hope to process. Charging appropriately is all about understanding your business and what your true costs are. If your “thinking” was the fourth one, I would love to hear how it’s working for you.

If a good day in dentistry is doing your best stuff with and for people who appreciate it, I have a lot of good days. My shift from product to process brought me the reward of people who asked for what I most wanted to offer them. Think you need better patients? How would you like more of those who ask? They’re probably already there; they just don’t know they need the life insurance yet.

The author can be reached at gdewood@seattleinstitute.com.

Gary M. De Wood, DDS, MS
The Seattle Institute for Advanced Dental Education
Former Clinical Director and Director of Marketing and Publications
The Pankey Institute
Key Biscayne, Florida

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