Saying You're Sorry

When is saying you’re sorry appropriate in the dental office? It may seem obvious that if you do something wrong, you should apologize. If you bump into someone, you say you are sorry.

I know many people that apologize over every little tiny thing, especially women. A lesson I recently learned is that sometimes “Sorry” can come with unintended consequences.

I had a patient about three years ago who had a completely non-restorable #19 that was causing pain. #18 was also deeply carious. This was one of my first surgical extractions out of school and instead of going straight for the handpiece, I started with elevating against #18; it promptly fractured. Large mesial caries were visible on the radiograph. I explained to the patient that the tooth was already compromised by the decay and that it fractured during the procedure. I apologized to him and offered to do a filling at no charge.

He was fine with this initially. Some months later, unbeknownst to me, he attempted to make an appointment for a toothache and was told he needed to make a payment on his large outstanding bill. He went to another office and was told that #18 would need a crown. The patient had many dental issues, numerous carious teeth, periodontal disease, and several possible RCTs. I don’t disagree that #18 could use a crown, but we were still in the disease management phase of treatment.

The patient decided that I had “ruined his tooth,” and that I should be responsible for a crown on 18. The office manager and I met with the patient and tried to reason with him. We showed him the x-ray. We offered to give him a discount on a future bridge. The only thing the patient wanted was for me to provide him with a crown. He repeatedly stated, “She apologized. She admitted it was her fault.”

I know I didn’t put the cavity in his tooth, but in his mind, I was 100% at fault. I don’t know that, if I had explained things differently, his understanding of the situation would have been different or if he was bound and determined to find something wrong so he wouldn’t have to pay. I do know that I say I am sorry many times every day.

Trying to be polite leads to several apologies per day, and many of them are unnecessary. In this particular case, it created more confusion than harmony. I am not taking “sorry” out of my vocabulary, but I will be a little more prudent when it comes to clinical situations.

Sarah Meyer, DDS