Most of the dentistry I’m doing today is repairing older dentistry, whether from leakage, decay, or breakage. One of the more challenging and grayer areas of dentistry is when to treat. Unfortunately, we live in a time when patients are guarded against over-diagnosis and overzealous treatment planning. The difficulty comes when their skepticism meets your honest and sincere concerns for treatment needs.
In an ideal world, I would alert every patient to anything and everything going on in their mouths that I would want explained to me, not just the “need to treat now” findings. I would say that, the majority of the time, I do a really good job with this. I spend extra time going above and beyond to inform and educate, with verbal explanations, photographs, and radiographs. However, I’m human, too. It’s difficult situation to walk into a room and have the patient start the exam by saying they don’t want you to find anything or the hygienist telling you that the patient doesn’t want to do anything unless it is broken or painful.
The internal struggle I face in these situations is an ever-present one. The people-pleaser in me wants to make this patient happy. But I’ve just been informed that their happiness is dependent upon my withholding information until things break or hurt, which isn’t in the patient’s best interest. In my experience, when I suppress that little voice telling me to make the patient like me, and I inform them of my concerns for future dental needs, even if nothing is decayed, broken, or hurting, I sleep better at night. That patient may, in fact, choose to wait to fix things until they have physical evidence of a “need” to treat, even if it means more procedures in the end. But at least it was their decision to wait, and I provided them with all of the risks and benefits necessary to arrive at that decision.
I’m working hard to squash that little voice each and every day that I practice dentistry. But let me tell you - she’s a persistent little bugger. Do you struggle with this? Does she ever go away? What are your best methods for dealing with this struggle?
Courtney Lavigne, DMD