As dentists, we're constantly under pressure to meet time expectations. Not only for our team, but also for our patients. Effective communication is key when the unpredictable occurs and an appointment runs longer than expected.
I was quickly reminded of how my communication would come into play when working on a patient scheduled for two crowns and buildups (#14 and 15), and an extraction (#16). I assumed the appointment wouldn’t take too long, and that he should expect to spend around two hours with us if everything went as planned. The patient seemed a bit anxious and kept checking his watch, so I knew that time was important, and that I better work efficiently and swiftly to help accommodate his expectations. The decay on the radiographs was quite large, and the existing fillings were leaking like a sieve. He began the appointment by asking, “so just how long will I be here today, because, no offense, but I’d like to be here as little as possible.” I thanked him for his honesty, and asked if he had somewhere he needed to be. Did he only budget until a particular time to be in the chair? I want to know time constraints up front and set myself up for success. If the patient did need to be somewhere sooner than I expected, then knowing this ahead of time helps in case I need to modify treatment.
With the clock ticking to get this guy out the door in a timely fashion, of course, the treatment would take a turn… Lo and behold, as I removed decay, I realized that at least one, if not both teeth were going to need endodontic treatment. After looking back in the notes, I saw that both teeth had been diagnosed for crowns over 1.5 years ago. As I preach to my patients daily, treat the problem when it is more conservative, rather than waiting for the problem to grow. Unfortunately, this patient had not heeded this sage advice.
So what to do? I led this patient through the “why” of the need to treat both teeth endodontically. I spent time showing him radiographs and intraoral photos—these tools help me illustrate the condition without having to convince the patient—they can see it in full color and in 14X life-size. Also, I discussed how waiting to do the treatment had been a likely factor in the progression of the caries and the addition of procedures onto the needed treatment for the day.
After explaining the need for treatment, he seemed annoyed, stating, “how much longer is this going to take, and how much more is this going to run me?” I replied, “I’m going to have a member of my administrative team come back and go over the change in the financial part of your treatment. They will make sure that you know without a doubt, how much the changes in today’s plan will affect your out of pocket expense. Also, I expect it to take about 1 hour longer, give or take. I can’t ever truly tell how long a tooth will take, but I will give you frequent updates as we work and let you know how things are progressing.”
When I told him that, it seemed to diffuse the situation. He just wanted to know. Most patients simply want to know what to expect at the beginning of treatment, as it pertains to finances, time, and post-operative concerns. He admitted sheepishly that he was worried that the root canals were going to hurt, and he was “just being a baby” and that he was concerned he would be in the chair until 5 p.m. It was only 11:30 a.m. at that point! I reassured him that he would be done with the whole procedure painlessly WAY before then!
The patient should be your partner as you work through a complex treatment plan, or a treatment that takes a turn in the projected path. Telling the patient how things are going at regular intervals, and positively affirming progress through the treatment keeps the patient well informed, builds trust and eases their anxiety. Although we work with teeth and dental terms daily, don’t forget that our daily verbiage is another language to the patient. Use layman’s terms, utilize photographs of the teeth and radiographs (if the condition is easy to see), and use comparison images so they can see why treatment is needed. If they understand their current condition, they will value the need for the treatment and be much more likely to follow your recommendations happily and refer their family and friends to you in the future.