In my previous article I argued the case for a number of candidates for the most important instruments in periodontics. My vote was for the ears.

Rather strangely, some may think, but I am serious in my choice. I read a figure the other day of 60-70%. This was the dropout rate for recall patients visiting periodontal specialist practices. This means that this number of treated patients are not getting the ongoing periodontal care that they need.

Is the same true for general practice? I get the feeling that it is. But before we even get to that stage we must consider the patients who do not take the treatment up in the first place, bearing in mind that many don’t know that they have periodontal disease and, if they do, they do not consider treatment a priority.

This is important for two reasons. Firstly, uncared for patients will ultimately suffer from the unnecessary loss of teeth with its subsequent health and lifestyle consequences. Secondly, your practice will suffer financially. It is much more cost-effective to retain a patient than to keep trying to acquire new ones.

So why the high number of dropouts? Firstly, there will always be some natural loss of patients due to relocation, death or other life changes. This is harder to deal with but not always insurmountable. Many more will simply leave because you do not give them what they want or because you do not educate them on what they need.

How do you find out what they want? By actively listening. By using the ears as the most important part of the communication process. Rather than getting struck off for considering your ears to be the main periodontal tool, you will be seen as the ultimate caring clinician who truly responds to his patient’s wishes. You will be able to carefully align the treatment the patient needs with what they actually want and they will love you for it.

Additionally, by listening to patients you will be able to find their ‘hot buttons’ that will motivate them to thoroughly clean their teeth day in, day out and religiously attend their recall appointments. Motivation of periodontal patients is crucial to long-term success.

Whatever issues patients may have that act as a barrier to care must be determined by you and then responded to. Listen, pause and then respond gracefully to their needs and desires within an entirely ethical framework. It is called ethical selling.

If you do not give patients what they ultimately want, they will become de-motivated. Some patients will request treatments that you cannot provide ethically. Let them go. But for the majority, giving them what they want will keep them motivated. It is perhaps the major determinant of successful treatment. Use the most important tools in periodontics and find out about your patients.