But why can't you just fix my tooth ?

 

Patients often come into the NY University School of Dentistry where I teach to treat their dental emergencies. They often have a particular symptom that is bothering them. The students often want to address the symptom immediately, but often they are required, in non emergency situations, to first do a comprehensive exam and treatment plan. 

It is not usual for these new patients at the school to initially express a resistance to taking a full set of radiographs and submitting to a full work up by their student. Often their student also wants to immediately care for the tooth thats bothering them, but our student dentists need to understand the importance of  performing a complete patient assessment prior to performing non emergency dental treatments.   Many problems that patients have are not terribly symptomatic, at least until that time when their conditions worsens and they are forced to seek "emergency care". For this reason and others, most of our emergency treatments are palliative in nature and not definitive care. 

Obviously is a patients has an acute infection or a tooth that is causing significant pain, something should be done for them to alleviate their "acute" problem, but once they receive emergency treatment, it is a dentists responsibility to  evaluate a patients entire clinical situation. It's important that our student dentists understand the need for the performance of a complete patient assessment prior to performing the non emergency dental treatments.We should  assess our patient's overall condition and come up with a treatment plan, or multiple different plans that might appropriate . This is principal that our students need to embrace, even when their patient maybe initially resistant. 

A patient may say, "I am here to address this one tooth that's bothering me and nothing else for now, but on that occasion if I'm in attendance,  I engage the reluctant patient and explain that often dental  treatments can be expensive and patients should be aware of their over all problems before committing funds to treating just one tooth. Many patients actually have multiple problems that may influence the type of treatment that will ultimately chosen. Teeth that have infections and/or large carious lesions may need multiple costly procedures to remedy and if multiple teeth are similarly involved, a patient needs to become aware of the extent of their problems, before deciding on expensive treatments to save just one tooth. After all, patients may have multiple choices to make, and options when they're deciding which teeth should be saved and which should be extracted.

Once I explain this to patients, most tend to relax, especially after I point out that it no one can force them to have any particular proposed treatment.  Still it is our duty to perform a comprehensive examination to determine the extent of their problems,  so that they can make better informed decisions on their subsequent treatment. Since no one can "force" them to have treatment, the "worst"case scenario   is that our school may not provide the particular treatment they desire ( because in our opinion it is not in their best interest and we try to "do no harm" to our patients) , but  they will still be free to seek a second or third opinion elsewhere. 

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2021/07/but-why-cant-you-just-fix-my-tooth.html - http://lspindelnycdds.blogspot.com/