Dentaltown March 2020 - 42

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dalmacija
Member Since: 04/14/15
Post: 12 of 42

Definitely show the patient the areas and also intraoral camera photos and X-rays. You also
need to think about the previous seller's treatment planning. You do not want to be in there
treatment planning aggressively on existing patients if he did not. If the patients show up to
their recalls, what's the harm in waiting? If it's "early occlusal caries" there's no way in hell I
would diagnose eight filings on a patient seen at the last recall if the doc did not treatment plan
anything, unless it was egregious and blatantly missed large decay that can easily be pointed out
to the patient. If you are not getting a stick with your explorer but you see brown stuff in the
grooves, leave it alone for now. You are going to lose patients if you start telling them they need
a ton of work while the other guy said the opposite. Slow-roll it. Good luck. ■
12/14/2019

jawbreaker
Member Since: 10/06/01
Post: 13 of 42

An intraoral camera is a godsend to show patients what you're talking about. Get one! I agree
with being careful about diagnosing a lot of stuff at the first visit. Tell them you're concerned
and will watch them. Then, on the next visit, do the worst ones. ■
12/14/2019

BuckeyeBrownie14
Member Since: 05/30/18
Post: 14 of 42

So you'd lower your standards as a practitioner just to keep someone happy? If they have
decay then they have decay, and they need to know about it. You aren't responsible for the state
of their mouths or their feelings (or, in this case, their mom's feelings). ■
12/14/2019

Elbow Deep
Member Since: 02/04/03
Post: 16 of 42

Frankly, yes. In the OP's situation, yes, old doc was conservative. But if you go in there and
call every incipient lesion a "cavity" when you have not gained their trust yet, these people will
leave-and leave you a nasty review, like another poster said.
It's a fine line the OP has to walk between gaining their trust and blowing the patients out
of the water with large treatment plans. You paid a lot of money for goodwill; don't flush it down
the toilet. With new patients, treatment plan whatever you see. ■

12/14/2019

davidpalmer
Member Since: 04/14/00
Post: 19 of 42

If you do not "watch" anything, say goodbye to a lot of existing patients. As a newbie and
someone they do not trust yet, you should spend your time bragging on the older doc, point out
the worst of the decay with the help of the intraoral camera, and also take pictures of other areas
that have minor decay and actually could be "watched" for six months or more.
If you diagnose more than a couple of cavities when the older doc has seen nothing for years,
watch out! Give fluoride gel and point out all the other places that need attention. Also, stain
in grooves of the molars is common and not necessarily decay. Giving the patient a mirror and
sticking the explorer in the tooth where you can literally let go of the explorer basically proves
your point to the patient. Good luck. ■
12/14/2019

Jamar M Jackson
Member Since: 04/03/05
Post: 20 of 42

"Dismiss." This is the worst thing you could possible do. Literally. Dismiss this patient and
the mom will tell dozens of friends about this experience, and the fallout will continue from
there as patients you've never seen start to call for their records to be transferred. Virtually
guaranteed bad online review.
Trust must be gained when diagnosing this much decay in a person who thought they were
decay-free. As far as excluding the parents because the kid is 20 years old? That again is not
what works best in these situations. The kid is home from college and the mom still makes the
appointments. Let's all live in the reality that this kid isn't yet making decisions on their own. It's

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Dentaltown March 2020

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