Truth or Consequences?

We are faced with a dilemma each day as we enter our dental practices to treat patients. It`s no secret that, given a choice, most patients would rather be anywhere else than undergoing any one of the various procedures we provide. Patients often are quite vocal about this, much to our dismay. Trying to justify our diagnosis, our fees, and often our very existence, puts us on the defensive. Dental professionals are generally a very compassionate group. We want our patients to be comfortable an

Beverly Maguire, RDH

We are faced with a dilemma each day as we enter our dental practices to treat patients. It`s no secret that, given a choice, most patients would rather be anywhere else than undergoing any one of the various procedures we provide. Patients often are quite vocal about this, much to our dismay. Trying to justify our diagnosis, our fees, and often our very existence, puts us on the defensive. Dental professionals are generally a very compassionate group. We want our patients to be comfortable and healthy, and to invest in dentistry that will be long lasting as well as beautiful.

Often, we are much too hesitant to deliver information that patients may not want to hear, such as, "The tooth needs a crown, not another huge filling," or "today`s planned cleaning will not be appropriate care, since you have periodontal disease." Why does it make us so uncomfortable to tell the truth, even though it is based on years of professional education and clinical experience? If we want only to deliver "good" news, we could just as easily call each patient, tell them "all is well," and then bill them for our services!

But patients actually do come to us for a report of findings: Are their teeth healthy, or is there a problem to address? No one looks forward to hearing that there is an unexpected problem, but we must uphold our professional obligation to patients by informing them of their problem, rather than sugar coating the message.

Simply telling patients to floss more, come in more often, or that we will "watch" the situation is a form of malpractice. None of the above scenarios are appropriate treatment models for periodontal disease. We owe it to each and every patient entrusted to our care to gather complete periodontal records, and, by evaluating these records, determine the hygiene diagnosis. Each diagnosis corresponds to an appropriate treatment.

Accurate diagnosis is based on scientific data, clinical signs, and symptoms, as well as the evaluation of the patient`s health history, radiological loss of bone, home care efforts, and progress over time. The process of determining an appropriate course of action for many of our hygiene patients requires critical thinking skills. Merely doing what is indicated on the schedule for today`s visit will not always be appropriate care.

Each one of us providing health care to dental patients must face this issue. Patients may like or dislike us, which is not the biggest area of concern. What`s at stake here is our professional standards and ethics, as well as the quality of care we deliver to patients. Are we accurately diagnosing the situation and offering appropriate choices for treatment?

Our self-esteem should not be a factor in any diagnosis. Patients deserve to know the truth; they pay us to evaluate their dental health. We, as caring dental professionals, must be able to deliver the information in a kind and compassionate manner. Whether we are liked is not the issue. It`s critical to offer options and choices to patients at the appropriate time. Our window of opportunity in treating early periodontal disease is 4-6-mm, before too much irreversible damage occurs. Patients can handle the truth. They appreciate knowing of their problems early enough to make a difference in the cost, discomfort and magnitude of the needed treatment.

Some patients may try to "shoot the messenger" when they don`t like the message, but that`s no reason to not tell the truth to each and every patient. How would you like to be treated?

Beverly Maguire, RDH, is a practicing periodontal therapist. She is president and founder of Perio Advocates, a hygiene consulting company based in Littleton, Colo. She can be reached at (303) 730-8529 or by e-mail at perioadv@aol.com.

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