Thursday, September 12, 2013

A Trip to the Dentist

Normally, we don't think of our dentists as being a part of our medical team.  I hadn't either until I developed Sjogren's Syndrome.  This autoimmune disease inflames the moisture producing glands in the body, such as saliva glands, tear-producing glands, making the areas the glands serve very dry.  In the mouth, without the normal flow of saliva, we have problems with eating and with our teeth.  So, I was forced to think differently about my mouth and my teeth in order to take steps to protect them.  Each time I see my rheumatologist, I give her an update on my most recent dental exam.

This year, however, my dental issues have been things I'd postponed addressing for as long as possible.  One of those issues was getting a crown for an upper molar that had broken almost ten years ago and a previous dentist has built up with amalgam as a temporary fix.  The amalgam had begun to crack, so this year would be the year of the new crown.

I do not have dental insurance.  My first question always is how much will this procedure cost?  My dentist offered to provide me with a written estimate that she e-mailed to me the next day.  Armed with that estimate, I could now plan for that expense.

Communication is as important between dentist and patient as it is between medical doctor and patient.  The dentist I see now is relatively new to me, and I have not figured out her communication style yet.  I do not doubt her expertise as a dentist.  What sometimes irritates me is a practice most dentists do but are smoother at it than this dentist, i.e. scheduling a procedure at the same time that another patient is getting a cleaning and check-up, leaving the procedure patient at a natural break and doing the check-up, then returning to the procedure.  My dentist, during my initial procedure to prepare my molar for the crown, left me twice and not really at natural breaks -- at least I didn't see them as natural breaks in the procedure.  How to deal with this?  I honestly don't know.  I suppose I could complain, but I doubt it would make much difference and would earn me a reputation as being a complainer about things that don't concern me.  Except this one does concern me.  I need to think about this.

Another communication issue was not including me in choosing the color/shade for the new crown.  I've had detailed conversations in the past with dentists who've given me crowns about the color I wanted for the new one.  If I'd realized that she had not asked me about the color while I was still in the office, I would have brought it up.  Perhaps I should have called her to let her know my preference.  As so often happens, my busy schedule interfered and I never called.  My bad.

At the clinic to receive my new crown, I waited 20 minutes in the chair for the dentist.  The assistant who'd brought me to the exam room arranged for a dental hygienist to administer the anesthetic so I'd be numb and ready to go when the dentist was ready.  And that's what occurred, along with an apology from the dentist for keeping me waiting.  She removed the temporary crown and inserted the new crown which fit perfectly.  Even I could tell that.  But she wasn't happy with it because the color was too dark for my teeth.  It popped out of my memory that she hadn't asked me about the color, and I had not called.  She showed me the new crown -- it's far enough back in my mouth that I could have lived with it probably, but she didn't ask me.  She decided to send it back to the lab to be done over at a different shade.  Then she proceeded to use shade samples to pick a shade that was appropriate.  I finally commented that I really liked the color of the crown that is next to my new one.  She started, surprised.  I almost laughed.  It never occurred to her to ask me.  She looked up the shade of the crown I liked and that's what she ordered for the new one.  I still have a temporary crown, and must chew with care on that side for the next two weeks.  But I think the next new crown will be perfect in every way.

All kinds of things block effective communication.  We forget to ask.  An interruption distracts.  Someone looks like she has it covered.  The point is that it's important to speak up, take the initiative to start the discussion, or in the case of my dentist, remember the patient may have something to say about it.  No one is perfect!  I did my best to help after I observed the dentist and figured out what I needed to do.  She wasn't going to ask me.  I would need to volunteer the information in a way that wouldn't annoy her or hurt her feelings.

Think of your dentist as being an important part of your medical team.  After all, unhealthy teeth can affect the rest of your body in bad ways.....


Nichole Mercado said...

I 100% agree. I'm lucky enough to have parents who know the importance of oral health that's why I had the pleasure of having excellent dental services since I was a toddler. Moving to another state it wasn't hard to find the same exemplary treatment with my Austin Dentist. I encourage everyone, specially the parents, to schedule a visit with their dentist if they haven't had on in a while. Parents should have their children familiar with their dentist so it can help build their trust with them as they grow old so they wouldn't neglect their dental needs.

Leigh Hamilton said...

Well said, Gina. Unfortunately, there are many people who don’t see their dentist as part of the medical team. What they failed to realize is that a bad teeth could be an indication of a more complex medical condition, which could’ve been avoided had it been recognized on its early stage. Anyway, I know that wasn’t the case for you, but I’m just pointing out some general truth in your statement about dentists being an integral part of the medical profession. Cheers!

Leigh Hamilton @ Arbor Ridge Family Dental