Join Elevated GP by visiting THEELEVATEDGP.COM In Part 2 of his conversation with Dr. Melissa Seibert, periodontist Dr. David Wong unpacks why patients actually decline treatment — and it's rarely the money or the dentistry. It's the connection you failed to build. He walks through the soft-skill work that's defined his career: reading where a patient sits on the decision-making scale, designing a separate consultation room so he can sit beside patients instead of across from them, and disarming fight-or-flight by finding common ground fast. He also shares one of the most underrated networking moves in dentistry — joining your local Chamber of Commerce — and how it helped him launch a practice from scratch. The second half pivots to the clinical: ridge preservation as a high-ROI skill for general dentists, how to think about bone graft material selection without getting overwhelmed by terminology, membrane selection for beginners through advanced users, and the specific brands David reaches for day to day. About the Guest Dr. David Wong is a board-certified periodontist and Fellow of the International Congress of Oral Implantologists — the only periodontist in Oklahoma to hold that distinction. He completed his periodontal training at the University of Missouri-Kansas City as chief resident, earned advanced implant and oral plastic surgery credentials from Temple University and the Misch International Implant Institute, and has published in the field of oral plastic surgery. Beyond his clinical work, he has spent his career studying the art of case presentation and patient communication. Chapter Markers Time Section 00:00 Pre-roll: Elevated GP 00:49 Welcome and episode preview 02:14 Why patients decline treatment — the connection problem 04:24 The mistake of trying to build trust in one appointment 05:06 Recommended books and resources on soft skills 06:44 Why David joins mastermind groups outside dentistry 08:35 The Chamber of Commerce — an untapped networking resource 10:41 How the Chamber helped David launch his practice from scratch 11:20 Ridge preservation as a high-ROI skill for GPs 12:30 Honest take on dental photography ROI 13:27 Bone graft material selection — keeping it simple 14:38 Allografts vs. xenografts and the global supply reality 15:18 Membrane selection: beginner, intermediate, advanced 16:19 The handling reality of amnion-chorion membranes 17:19 When primary closure matters 17:53 Non-resorbable / PTFE membranes — when they help, when they hurt 19:04 Subscribe CTA 19:20 The specific brands David uses day to day 20:35 The one thing David has invested most in: case presentation 21:09 Inside David's consultation room setup 23:04 Three resources for learning case presentation Key Takeaways On why treatment plans get declined. When patients say "I'll go home and think about it," dentists default to "they don't value the dentistry" or "they can't afford it." David's argument: the most common reason is that you didn't build trust or form a connection. People will spend $20,000 on a European vacation but not on asymptomatic dental work — that's a comparison about trust and felt need, not budget. Connection is a long game, not a five-minute pitch. New dentists try to close trust in a single appointment. David's reframe: you'll see this patient over years. Foster the relationship as long as it takes, and they will do the treatment — maybe not all at once, but eventually. The "I'm the doctor, you're the patient" model breaks in fee-for-service. Patients in a fee-for-service practice are decision-makers, not compliant subjects. You have to meet them as one. Design the room around the conversation. For any case over roughly $1,500, David moves the patient to a dedicated consultation room and sits side-by-side at a table — not across the operatory chair. He pays attention to where he's seated relative to the patient and the door. He has even recorded his own case presentations on camera and had them coached. The Chamber of Commerce is one of the most underused networking moves in dentistry. Every city has one. Dues are minimal or free. You get a room full of local entrepreneurs — publishers, contractors, surgeons, service providers — solving the same problems you are, just in different industries. When David launched his practice from scratch, the Chamber funded part of his open house, ran his ribbon-cutting, and brought a crowd. Get your CE ROI right. Start with skills that pay dividends immediately — molar endo, ridge preservation/socket grafting. They have low downside (a missed socket graft is no worse than not grafting at all), short learning curves, and you'll actually use them weekly. "Sexy" CE without immediate clinical application sits unused. Keep ridge preservation simple. Don't get lost in the 70/30 vs. 50/50 mineralized/demineralized debate. David teaches just two categories: mineralized cortical bone, or mineralized cortical-cancellous bone. That's it. For membranes, beginners should default to a long-lasting resorbable collagen membrane. The fancier options (cross-linked, titanium-reinforced, amnion-chorion, PTFE) are handling-skill problems before they're outcome problems. Case presentation isn't about "salesy words." It's about reading non-verbal cues, responding appropriately, and conducting the conversation — not delivering the right script. Notable Quotes "It's not necessarily just because they don't want it. It's not necessarily just because of financial constraints. It's because we didn't build the trust. We didn't form that connection." "You're going to see this patient more than one time. Hopefully ten years from now they're still your patient — so you have to foster that relationship as long as it takes." "We'll spend $20,000 on a European vacation. We won't spend $20,000 on dentistry when we're asymptomatic and have no known issues." "You spend all that money [on a photography setup] and you still use your intraoral camera to sell single-tooth dentistry. Good job." "Two, three years later, I am the guy where they're just like, 'Dr. Wong, just take my money and do it.'" "A lot of times dentists think that case presentation is using the right words — salesy words. That's not it at all." Resources Mentioned Books on influence, communication, and mindset Influence — Robert Cialdini Pre-Suasion — Robert Cialdini (the "second one" referenced in the conversation) Vanessa Van Edwards' work (and her courses on the Masterclass app) How to Win Friends and Influence People — Dale Carnegie How We Decide — Jonah Lehrer Books by Jonah Berger The E-Myth Revisited — Michael Gerber As a Man Thinketh — James Allen (~50 pages, mindset) Organizations and programs Your local Chamber of Commerce Local Toastmasters (for speaking) Spear Study Club masters program The Elevated GP (Dr. Seibert's virtual study club) Paul Homoly's case presentation program Clinical products David uses day to day Membrane: Mem-Lok resorbable collagen (BioHorizons) — current default Membrane (when available): OsseoGuard / Ossix Plus (Dentsply Sirona) — currently on hold Bone graft: MinerOss mineralized cortical or cortical-cancellous (BioHorizons) Bone graft (alternate supplier): Symbios mineralized cortical (Dentsply Sirona)
