DentaltownUK July 2018 - 44

message board

I think I led off this thread with the wrong title. I am not trying to imply how to formulate
a manipulative conversation with the patient, but I am trying to imply that you can address a
patient completely in the wrong manner and discuss things that the patient is not interested in
hearing, and thus will cause you to miss the mark with the patient. I guess a better title would
have been 'How to miss the mark' or even 'It's the questions you ask'. ■

24/2/2018

alanrw
Member Since: 16/05/11
Post: 40 of 114

Lots of wear which could be handled by doing nothing, cosmetic recontouring or veneers.
Again, depends how she feels about her smile and what she is willing to do. I think Dr. Nosti
posted this case simply because there is a lot going on and it is typical of what comes into our
offices on an almost daily basis.
We do have an obligation to advise the patient of what we see and possible sequalae from an
ethical standpoint as well as a medico-legal standpoint. Imagine if 19 blew, she ends up in an
emergency room and then your records are requested. You saw it and did nothing. Not saying
this scenario can easily happen but it is definitely a possibility. For all we know, 19 has been
acting up from time to time and if she doesn't disclose it because she knows it needs an endo or
extraction and desires neither. I have seen that scenario time and time again. "It aches for a few
days and then goes away."
In most of our practices, this case would not go to full-mouth reconstruction because most
patients are not interested, or if they are, there are financial obstacles in their paths. True, there
are the guys who work in the high rent areas and do these cases day in and day out but most of
us do not find ourselves in that local. ■

24/2/2018

Timmy G
Member Since: 14/04/02
Post: 43 of 114

I'm personally not a huge fan of these questions. They can be helpful in the right context,
but I think too often patients give us the answer that they think we want to hear, because people
know what they are 'supposed' to say.
I lean more towards things like, 'Do you have any worries about keeping your teeth?' 'Do
you have friends or family that have lost many teeth or with dental problems? If so how are they
getting along?'
Often this opens up a line of questions that can be very useful. Is it function, because mom
had dentures and was miserable? Is it smile because sister had braces and a nicer smile, and they
didn't and that's always bugged them? Is it unwarranted hopelessness because all four grandparents had no teeth at the end of life and they figure the same for them? ■

24/2/2018

robr
Member Since: 31/05/07
Post: 47 of 114

Fair point. Thus, the importance of follow up questions. And we have to listen because
when we listen carefully we can start to understand the core issue(s). For example, I had a couple
of patients tell me recently that they want to keep their teeth. These were younger people and
genuine in their concerns. So, a follow up could have been something like, 'What is it that makes
you think you might not be able to keep your teeth?' It's a simple question, but the goal is to keep
getting more information.
You are absolutely right in asking open-ended questions. Just the other day it took me 10-15
minutes of prodding/probing with a patient to get to the real issue regarding her feelings. I'm
not the best at asking the right questions, but I keep asking something until I feel like we have
all of the information. ■
24/2/2018

44

SUMMER 2018 // dentaltownuk.com


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Table of Contents for the Digital Edition of DentaltownUK July 2018

Mike Gow: A Consultation with...Alasdair Gillies
Howard Speaks
Continuing Education Update
My First Clear Aligner Case
Show Your Work: Guided Implant Surgery (Part 1)
Message Boards: How Long Is your Hygiene Appointment and What Does She Do?
Cover: Wellcome Collection Exhibition
It's All in the Chemistry
Time Out
Dental Aid Network
Message Boards: It's What You Say and How You Say It
Advertorial Tipton Training
BACD News
DentaltownUK News
Students
Quiz
DentaltownUK July 2018 - Cover1
DentaltownUK July 2018 - Cover2
DentaltownUK July 2018 - 3
DentaltownUK July 2018 - 4
DentaltownUK July 2018 - Mike Gow: A Consultation with...Alasdair Gillies
DentaltownUK July 2018 - 6
DentaltownUK July 2018 - 7
DentaltownUK July 2018 - Howard Speaks
DentaltownUK July 2018 - 9
DentaltownUK July 2018 - Continuing Education Update
DentaltownUK July 2018 - 11
DentaltownUK July 2018 - 12
DentaltownUK July 2018 - My First Clear Aligner Case
DentaltownUK July 2018 - 14
DentaltownUK July 2018 - Show Your Work: Guided Implant Surgery (Part 1)
DentaltownUK July 2018 - 16
DentaltownUK July 2018 - 17
DentaltownUK July 2018 - 18
DentaltownUK July 2018 - Message Boards: How Long Is your Hygiene Appointment and What Does She Do?
DentaltownUK July 2018 - 20
DentaltownUK July 2018 - 21
DentaltownUK July 2018 - Cover: Wellcome Collection Exhibition
DentaltownUK July 2018 - 23
DentaltownUK July 2018 - 24
DentaltownUK July 2018 - 25
DentaltownUK July 2018 - 26
DentaltownUK July 2018 - 27
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DentaltownUK July 2018 - It's All in the Chemistry
DentaltownUK July 2018 - Time Out
DentaltownUK July 2018 - 31
DentaltownUK July 2018 - Dental Aid Network
DentaltownUK July 2018 - 33
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DentaltownUK July 2018 - Message Boards: It's What You Say and How You Say It
DentaltownUK July 2018 - 41
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DentaltownUK July 2018 - Advertorial Tipton Training
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DentaltownUK July 2018 - BACD News
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