Dentaltown June 2018 - 44

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Often this opens up a line of questions that can be very useful. Is it function, because mom
had dentures and was miserable? Is it smile because sister had braces and a nicer smile, and they
didn't and that's always bugged them? Is it unwarranted hopelessness because all four grandparents had no teeth at the end of life and they figure the same for them? ■
2/24/2018

robr
Member Since: 05/31/07
Post: 47 of 114

Fair point. Thus, the importance of follow up questions. And we have to listen because
when we listen carefully we can start to understand the core issue(s). For example, I had a couple
of patients tell me recently that they want to keep their teeth. These were younger people and
genuine in their concerns. So, a follow up could have been something like, "What is it that
makes you think you might not be able to keep your teeth?" It's a simple question, but the goal
is to keep getting more information.
You are absolutely right in asking open-ended questions. Just the other day it took me 10-15
minutes of prodding/probing with a patient to get to the real issue regarding her feelings. I'm
not the best at asking the right questions, but I keep asking something until I feel like we have
all of the information. ■
2/24/2018

GulfDDS
Member Since: 10/24/03
Post: 98 of 114

How's the patient going to even be able to make any kind of decision concerning the prognosis of their dental health if they don't hear from us all about their current status? Present what
you see and let the patient decide what to do. I will tell you I see a lot of elderly snowbirds for
emergencies ... toothaches, loose teeth, broken teeth, failing bridgework, TMD issues, inability
to chew the foods they like, choking on their food, indigestion, acid reflux, apnea, etc.
I see a lot of general severe wear cases with a tooth with exposed pulp needing root canal but
no room to restore. I ask them if any of their previous dentists have suggested full restoration
to their original bite and almost invariably they answer, "Yes but the dentist didn't seem serious
about it so neither was I." I then ask them, "How would you like to have done this 10, 15 or 20
years ago at those fees and still be enjoying them today with good preventive measures?" I don't
want to be that dentist who wasn't serious about my patient's future (as well as present) dental
health and I tell them this. ■
4/4/2018

John Nosti
Member Since: 02/23/04
Post: 109 of 114

Tom, does it bother you when patients say they cannot afford it? Do you not recommend
treatment because you think they are going to tell you that? Do you feel teeth are or are not
important? ■
4/5/2018

TomWhitdmd
Member Since: 01/25/12
Post: 110 of 114

Honestly, it used to, but not much anymore. It was frustrating as I saw it as I wasn't explaining it clear enough, or not using the right words, when in fact I was trying to "sell" something to
someone who did not want what I was offering or did not see the value in it.
(One of the first Spear lectures I attended was such a relief as he was describing this exact
thing). I tell everyone what I see and recommend, offer for them to come back for some IOPs
and discuss more of what I'm seeing, and they can see also. The difference is now I don't push it
at all. If they want to, great. If not, we will just fi x things as they break and do the best we can,
this is great too. Doesn't bother me much anymore, not like doing pulpectomies on first molars
for almost nothing and parents not bringing them back until it hurts again because they could
not get $500 for me to finish the RCT. ■

JUNE 2018 // dentaltown.com

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