DentaltownUK July 2018 - 45

How's the patient going to even be able to make any kind of decision concerning the prognosis of their dental health if they don't hear from us all about their current status? Present what
you see and let the patient decide what to do. I will tell you I see a lot of elderly snowbirds for
emergencies ... toothaches, loose teeth, broken teeth, failing bridgework, TMD issues, inability
to chew the foods they like, choking on their food, indigestion, acid reflux, apnea, etc.
I see a lot of general severe wear cases with a tooth with exposed pulp needing root canal but
no room to restore. I ask them if any of their previous dentists have suggested full restoration
to their original bite and almost invariably they answer, 'Yes but the dentist didn't seem serious
about it so neither was I'. I then ask them, 'How would you like to have done this 10, 15 or 20
years ago at those fees and still be enjoying them today with good preventive measures?' I don't
want to be that dentist who wasn't serious about my patient's future (as well as present) dental
health and I tell them this. ■

GulfDDS
Member Since: 24/10/03
Post: 98 of 114

4/4/2018

Tom, does it bother you when patients say they cannot afford it? Do you not recommend
treatment because you think they are going to tell you that? Do you feel teeth are or are not
important? ■

John Nosti
Member Since: 23/02/04
Post: 109 of 114

5/4/2018

Honestly, it used to, but not much anymore. It was frustrating as I saw it as I wasn't explaining it clear enough, or not using the right words, when in fact I was trying to 'sell' something to
someone who did not want what I was offering or did not see the value in it.
(One of the first Spear lectures I attended was such a relief as he was describing this exact
thing). I tell everyone what I see and recommend, offer for them to come back for some IOPs
and discuss more of what I'm seeing, and they can see also. The difference is now I don't push it
at all. If they want to, great. If not, we will just fix things as they break and do the best we can,
this is great too. Doesn't bother me much anymore, not like doing pulpectomies on first molars
for almost nothing and parents not bringing them back until it hurts again because they could
not get $500 for me to finish the RCT.
Spear talks about a way to filter patients, because as a general dentist we really don't know
what some people are expecting of us (a Mayo Clinic or doc in the box). So, you either brand
yourself and you have a good idea of what patients are expecting or you have to have a way of
asking each patient what they are expecting. Otherwise you are wasting your time talking to
patients who don't want treatment and you don't miss opportunities to present treatment to
those who want it ... or at least the option.
So when I see patients for periodic exams and see things that I think will be potential
problems or issues in the future, I simply tell what I'm seeing and if they would be interested in
options to correct or prevent from worsening. In 99.9% of cases they are not interested. And if
you can't do a composite veneer for the fee of a four-surface composite (less the $140) then you
probably will not get many bites on just improving esthetics. ■

TomWhitdmd
Member Since: 25/01/12
Post: 110 of 114

5/4/2018

Talk the talk!
Search: 'What You Say'
Dr. John Nosti shares a case to get Townies thinking about their soft skills when it comes to patient communication and treatment acceptance. To share your thoughts, go to dentaltown.com
and search the message boards for 'what you say'-this conversation will be the top result.

dentaltownuk.com \\ SUMMER 2018

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