KeystoneExplorer | Fall 2023 17 dentistry issues Q • Remember your patients want to feel safe, be heard, and know that their well-being is your biggest interest. • “Get the endodontic monkey off your back” and invite the endodontist to carry and solve the monkey on your back problem. Then you can proceed treating your patient that needs six veneers which is a place that you enjoy and can impact the life of patient. 3. HANDLING THE PATIENT THAT WANTS A NEW DENTIST • Often, and now more so than ever before, patients see us, we solve the situation predictably, they have a positive experience, and then they say, “I am looking for a new dentist.” Our job is to find out why and have your permission to share that reason back to you WITHOUT JUDGMENT, OPINION, OR BIAS. Sometimes they report that my dentist just pops in, says a few words, and pops out. The clinical assistant says what I need, and I am supposed to schedule time. My dentist does not ask me what I would like to change in my mouth. The dentist TELLS me. I feel rushed. I see a different dentist every time I go in there. They don’t explain anything and so on. • Meet with your endodontist and welcome feedback. We are just the messenger. Whatever the feedback is, positive or negative, it is better being shared in a oneon-one vs. Yelp! This gives you an opportunity to solve the breakdown because, if it is negative, there may be a trend you want to change and one you may not even be aware of. This feedback circle goes both ways! 4. BEING HONEST ABOUT SPECIAL EQUIPMENT • Your patients often present with the comment, “My dentist says you have special tools.” This is true but that is only a half truth. Our real “special equipment” is advanced 2–3 year specialty training and years of experience. The “special equipment” is SKILL. Don’t water it down. Maybe the treatment is outside your skill level. I could not do a veneer if my life depended on it…not a good one, anyway. • This is not admitting failure, it is celebrating knowing the patient benefits from your team. Patients get this right away. Some dentists think they are sending production out the door. The smart dentists we know have their interdisciplinary team and are, by far, the most successful and satisfied dentists we know. The interdisciplinary team opens all the team’s eyes; especially the restorative dentist who now has interdisciplinary skills at their disposal to free you to focus on what you enjoy and are good at…probably profitably, too. 5. DIAGNOSING THE “CRACKED TOOTH SYNDROME” (CTS) • The illusive “Cracked Tooth Syndrome” exists in anywhere from 10–25% of your practice’s patients right now and is undiagnosed. Diagnosing sooner than later can prevent an endodontic misdiagnosis or prevent an unrestorable vertical fracture. 6. BE GUIDED BY AAE GUIDELINES FOR DIAGNOSTIC, TREATMENT PLANNING, AND ENDODONTIC TREATMENT COMPETENCY • Endodontists set the standard for endodontics. If the endodontist’s standards cannot be met, such as need for microscopy, 3-D imaging, regenerative procedures, radicular surgery, treatment of complex injuries, then the general dentist should refer the patient to the endodontist. In documenting general dentist endodontic competency, AAE Case Difficulty Assessment notes “that dentists should upgrade one’s skills to meet the standard of practice established by the endodontic specialty.” • The AAE considers the following as “high difficulty” and that all dentists be able to defend their endodontic treatment skills to successfully treat: for example, extreme curvature (greater than 30 degrees), S-shaped curve, indistinct calcified canal path, nonsurgical or surgical retreatments, anesthesia difficulty, limited opening, extreme tooth inclination or rotation, resorption, immature tooth, horizontal root fracture, endo/ perio lesion, confusing diagnosis, extreme difficulty in taking accurate radiographs, interpreting radiographs, performing pulpal tests, and trauma conditions. 7. PAVING YOUR WAY WITH WORDS • Tell every patient every time you prep a tooth that your clinical impact may be the final stimulus to cause pulpal breakdown requiring you to perform endodontics or you may want to bring in your endodontic specialist. 8. DO’S AND DON’TS TIPS • Don’t prescribe antibiotics for a toothache, which is a pulp ache, which means the diagnosis is a pulpitis, not a periradicular infection.
RkJQdWJsaXNoZXIy MTY1NDIzOQ==