You can't handle the truth?

Often new patients start with an emergency visit. Usually its best to take an x-ray of the tooth that's bothering them and try to eliminate their emergency. While I am often tempted to suggest we do a more comprehensive radiographic examination on an "emergency" visit, it usually is not the best idea.

I was taught, by a mentor dentist, that when a patient comes in with a problem, its best to try and help them right away in order to "win their confidence".There  is some wisdom there, since talking alone doesn't engender trust as much as successfully handling their emergency. Also giving too much "bad news" to a patient their very first visit is not a recipe for success!

Last week a youngish patient came in with a perio abcess on tooth #31. I could probe 10+ mm. Instead of just taking one radiograph of the tooth in question  and handling her emergency , I suggested a full set of Radiographs. I figured that her perio condition might not be isolated to tooth #31.  This survey showed  generalized moderate to severe  periodontitis of her posterior teeth. Now the cat was out of the bag and I explained that tooth #18 was hopeless and tooth number 31 had a questionable prognosis. She was understandably  upset since no one had told her this before.

I went ahead and root planned #31 and gave her an Rx for Doxycycline.  I asked her to return in a week for an observation and a general check up and  cleaning.  She scheduled a follow up appointment before she left.

The next day, I noticed a brand new two star review on my  Zoc Doc account ( an extremely low rating) and I told my office manager that I suspected our new patient had given us a low rating. There was no way to be sure, since it was left anonymously but I started to suspect that our new patient wouldn't be keeping her next appointment.

Sure enough this appointment was cancelled and my patient requested that her radiographs be sent to her via email. She reported that the tooth I treated felt better, but I guess sometimes the road to hell is paved with good intentions; If I hadn't done a thorough perio evaluation and taken a full set of radiographs, probably she would have returned for her follow up cleaning and I would have been able to break the bad news more slowly at a second or possibly third visit. Instead I was the messenger bearing bad news and I was "shot". If I had only followed my mentors advice I would have been her hero instead of the goat. Sometimes people are just not ready for bad news!

from Ask Dr. Spindel - http://ift.tt/2rnSLVF - http://ift.tt/1SpPbm6

Comments

Post a Comment

Popular posts from this blog

Help! My Child is Terrified of the Dentist

Image
If you’re the parent of a young child, you know their brains are similar to sponges that soak up everything around them—especially in their first five years, which neuroscientists say is when they’ll do the most learning and developing in their entire life. At this formative time, your child may amaze you with what they notice: your facial expressions, the different tones of your voice, and your habits. If your habits include regular dental visits and an excellent oral hygiene routine, they’ll notice and want to emulate you. If you happen to feel anxious about your dental visits, or you groan when you’ve got to floss and brush, they may synchronize and feel your dread. This could lead to dental fears that stick with them for years—potentially a lifetime! Kids Can Be Courageous If you’re feeling guilty right now, go ahead and put that away as it won’t serve you or your little one. Everyone has some room for improvement, and Coastal Pediatric Dentistry® is here to help show you an
Read more

Going for the Gold?

Image
On the left is the older allow, on the right the new one that my lab has chosen to use The cost of a penny weight of pure gold is currently $79.53. The cost of a penny weight of pure palladium is $130.6. It used to be that palladium was added instead of gold to the precious metals often used for pfms, but now laboratories are finding that palladium is no longer affordable. The lab that I am using has just changed the formulation of the metal it's using to one that has more gold than palladium. I really do not mind, but metals with more gold are softer and often easier for a dentist to accidentally polish off delicate margins. It is important when polishing "higher gold" formulations to exert less hand pressure when performing the final polishing of the crown's margins. Other wise there should be no problem with this change. Traditionally labs have chosen alloys with higher gold percentages for optimal esthetics, since alloys with higher concentrations of
Read more

Tongue Ties: What Parents Need to Know

Image
For a long time, people just didn’t seem to know much about tongue ties. In the early years of my practice, few of my patients had ever heard of a tongue tie. When I pointed out that they or their children might be tongue tied, I was often the very first practitioner who’d mentioned it to them. When I told them that a tongue tie might actually be the root cause of their oral myofunctional issues, or even their sleep apnea , I’m sure that some of them thought I was crazy. But in the last few years, things have changed so much! Initially, there was a small increase in the number of patients who were contacting me specifically about tongue ties. Dentists and orthodontists also began reaching out more frequently to discuss the application of myofunctional therapy exercises to tongue tie treatment. But in the last year or so, that little bit of interest has become a surge of awareness. Tongue ties and their effects on health and craniofacial development are finally becoming mainstream.
Read more