Dentaltown October 2021 - 26

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case study
Don't Slight Senior Care!
In my 46 years of practicing, I have learned too many dentists treat older patients
with indifference related to how they look. Many of these elderly patients came to me
sharing their frustration with their former dentists for not taking their physical oral
characteristics seriously.
The case I am sharing is emblematic of situations where the patient's goals were
ignored to the extent that her daughter, after seeing my marketing material, brought
her mother to see me with the hope that I could render care that was appropriate for her
condition. Her mother, Margery, had been getting dental hygiene care for years with
the smile you see here. Margery was never asked about her dental goals, which were to:
1. Preserve as many teeth as possible.
2. Improve her smile.
3. Have a healthy mouth.
Is that what you see here? Margery inferred her dentist was just waiting to make
her full dentures. There was, in my opinion, a complete breakdown in communication.
Once Margery and her daughter were interviewed, it became obvious to me that Margery
wanted a course of action that would meet the aforementioned goals.
A course of action was presented to both of them:
1. Control caries.
2. Orthodontics. (I asked if the patient would be willing to wear braces.)
3. Open her bite.
4. Eliminate partials.
5. Place veneers/crowns for a pleasing smile.
I wasn't concerned about presenting a fee that would enable the care to be rendered.
by Dr. Joe Whitehouse
Dr. Joe Whitehouse graduated
from the University of Iowa
Dental School in 1970. During
his career, Whitehouse
brought three other practices
into his own and adopted a
totally minimally invasive
approach to dental care.
He was a co-founder of the
World Congress of Minimally
Invasive Dentistry, serving as president for two terms.
Whitehouse also earned a master's degree in counseling,
enabling him to treat many fearful/apprehensive
patients without drugs. He has written about dealing
with fearful patients and authored articles on minimally
invasive dentistry and clinical issues dentists face.
26 OCTOBER 2021 // dentaltown.com
In my experience, dentists worry about presenting a big fee that will be rejected, therefore
robbing many patients of making an informed decision. Too often a patient presenting
with a certain look often causes a projection on the part of a dentist to tone down the
treatment plan to fi t the dentist's view of what the patient can afford.
Here, the patient accepted the treatment plan and fee because I provided a treatment
plan that fi t the patient's goal and quoted the fee straightforwardly. After two years,
we started the case when the patient was ready.
Case study
As you can see from Figs 1-7, the case was in 100% overbite and caries were present.
The periodontium was totally sound. Clinically, there was no way to restore the case
without CAMBRA, so that was implemented. Margery understood the importance
of maintaining her investment. Orthodontic brackets were placed on the maxillary
arch for two months of activation and two months of retention. The lower arch was
restored for a foundation with a bridge on the right side.

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Dentaltown October 2021

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