Dr. Drew reminds us that the final decision on treatment always lies with the patient

“I have how many cavities?”

An important theme that I’ve addressed in my first two columns has been COMMUNICATION. It is at the heart of most problems between dentists and patients. Improved communication can prevent the escalation of frustration that patients experience when not enough information is shared. Here are two specific examples where good communication is essential in the dental office:

The first issue that we often encounter involves the patient who has had a low number of cavities in the past, and then all of a sudden in one appointment is faced with several cavities all at once. How can that happen? Typically, this discovery is made through cavity detecting x-rays (bitewings) that identify the areas between teeth that the human eye can’t see and for someone who has had a low rate of decay, these x-rays are taken less often, possibly only every two years. The shock of this realization can be remedied easily by sharing with the patient that, if we see changes on the x-rays, we then have to make a determination as to which areas require treatment, and which can be observed and possibly reversed.

Factors such as past dental and medical history, as well as sugar consumption, play a role in this decision. Some dentists may decide that the area has reached the point of requiring a filling, and others may be willing to see if the condition can be managed. It should be made clear that fillings could be required in the future if other attempts fail. Different dentists can have different clinical judgements in this situation, but that doesn’t mean that the one recommending treatment is trying to take advantage of the patient or that the one suggesting the situation be observed for a period of time is being neglectful.

It is always useful to spend a few minutes showing the patient the areas in question through photos or live camera so they can see for themselves what is being discussed. Ultimately, dentists need to present the information and options, patients need to ask questions and through this exchange a decision can be reached that will satisfy everyone involved. The final decision always lies with the patient as to whether to proceed with treatment or even get a second opinion.

On a related note, when a dentist says that someone ‘needs’ something it’s usually a good start towards a misunderstanding. To be clear, there are times where a dentist has in fact used those words, but there are also times when a patient may misinterpret and those are the words they think they heard. Once again, it’s all in how the information is delivered to the patient, and that is always the responsibility of the professional.

The bottom line is that there are very few things in dentistry that patients need – certainly acute infection and pain should be treated, but people live with all kinds of dental problems that are not life threatening AND people can survive with no teeth at all!

First things first, patients need to clearly understand the problem. Once that is accomplished we make a concerted effort to go over all of the options available, which can include no treatment, short term options, and long term options. As long as the patient understands the consequences of their choice, we will support any decision that is made.

It’s human nature to make assumptions, especially if you don’t receive enough information. We encourage patients to ask questions about anything. It might seem like a basic concept however, if patients are not made to feel comfortable about asking, they won’t. Historically, people have been taught not to question professionals, yet we can’t know what someone is thinking or if they’re feeling confused. Dentists should also not assume patients understand simply because they have stated facts. We need to do everything possible to clearly explain your condition and be aware that everyone has a different level of understanding of these complicated issues. The dental office can be very intimidating, but sharing information can help break down the walls of mistrust and make for a more pleasant experience. Go forth and reach out with your questions at your next visit!

Should you have any questions that we might help with, please contact us at [email protected], or call at (705) 788-3067.  And for more information on our practice, please visit www.drdrew.ca.

You may also be interested in these articles by Dr. Drew:

Dr. Drew explains how Dental Benefit Plans work

Two-way communication is a priority in Dr. Drew’s office

Drew Markham

Drew Markham DDS

Dr. Drew earned an Honours Bachelor Degree in Physiology from the University of Toronto in 1993, and his Doctorate of Dental Surgery from the University of Michigan in 1998.

He has undertaken extensive post-graduate training in cosmetic and neuromuscular rehabilitation, which led to further training in orthodontics, sleep dentistry, and dental implants. Dr. Markham has fellowships from the Las Vegas Institute (LVI) and the International Association of Physiologic Aesthetics (IAPA). He has served as one of three Canadian clinical instructors, and also as a regional director for the Las Vegas Institute since 2008. Most recently he served as president of the International Association of Physiologic Aesthetics – a 500 member organization dedicated to the comprehensive care of their patients.

Dr. Drew along with his wife, Janet, and their 2 sons, came to Huntsville in 2005.