Family Health Magazine - DENTAL HEALTH
Dental Patient Treatment Decisions
Determining when treatment is necessary
Michael has seen the same dentist for over 20 years. When his dentist recently retired, he made an appointment with the new owner of the office. The young dentist seemed very nice, with an appropriate display of degrees and diplomas replacing the ones of his former trusted dentist. Since Michael was not aware of any problem with his mouth or appearance, he was shocked to be given a long list of required treatments and associated costs. Confused and worried, Michael wonders whether this amount of treatment is necessary.
People often feel uncertain about recommendations for dental work. Sometimes, pain and issues with function or appearance require scheduling a trip to the dentist. At other times, recommendations are made after a routine dental check-up and cleaning.
If you feel unsure about how to proceed, the questions on the Dental Treatment Checklist (see sidebar) are a good place to start.
More than one plan
Often, different levels of treatment approaches can be provided for various diagnoses. As an example, the University of Alberta first-year dental students are taught that treatment can vary from the ideal to the practical to a holding plan.
- An ideal plan – This plan assumes that you want the very best, most sophisticated treatment. Where necessary, the dentist may involve and guide a team of specialists. You have the time needed to complete treatment, and the money required to pay for it.
- A practical plan – This strategy presents alternatives that take budget, time constraints and other factors into consideration. For instance, if you do not have dental coverage, you may not be able to afford the most complex treatment. Perhaps the timing may not be right. For instance, a university hockey player might delay sophisticated treatment until his playing days are over and he is at less risk of a mouth injury. The purpose of a practical plan is to offer realistic solutions.
- A holding plan – This short-term fix solves a problem just until treatment can be upgraded to a practical or ideal plan. For instance, an oilfield worker may be on a three-week work rotation, followed by only a few days back home. Since time is so limited, a procedure that temporarily manages pain and allows function may be used first. Once the worker is more available, treatment can be ramped up to a practical or even ideal plan. This also allows time to think about which treatment plan to choose, as well as to check on insurance coverage.
A strategy that deals with doubt
If you leave the dentist’s office feeling confused about the treatment that has been suggested, follow these steps to make a decision.
- Talk it out – Make a consulting appointment with the dentist who proposed the plan. This appointment is designed to allow you to talk to the dentist, not for any treatment. Ask for a written estimate of the treatment planned, the cost and number of visits required. By the end of the visit, you should also know what you will need to do as a patient, and about any follow-up required.
- Get a second opinion - If this discussion with the dentist does not resolve your questions, another opinion is always an excellent idea. Bring along the written plan from the first dentist when you go for the second opinion.
- Don't be surprised if the two plans do not match exactly. Just like building a house, there is more than one approach to designing treatment.
You should feel comfortable asking questions of your dentist. Once you make your decision, you should be able to trust that you are receiving the best care available for the investment of your time and money.
Michael schedules a consulting appointment with the new dentist, so that he can ask more questions. He also gets a second opinion from the dentist of a friend. After careful consideration, Michael decides on a practical treatment plan that will address issues without exceeding his insurance coverage.
A Dental Treatment Checklist
- Were you aware of the problem being proposed for treatment? Did you approach the dentist because of a functional problem or concern with appearance?
- What kind of tests were done? Were X-rays or other sophisticated imaging tests used? If images of your teeth and the soft tissue inside your mouth were made, ask that they be shared with you. As it is hard to see the structures inside the mouth, pictures can help you to understand what is happening.
- Did anyone sit down with you to explain the diagnosis for the treatment plan being presented?
- Were you given a list of the problems requiring the treatment being proposed? Health care providers are taught to break down various problems and present them as diagnoses. These diagnoses are then used to create a treatment plan or a list of possible treatments. For instance, pain in a tooth might come from any one of a number of triggers. A crack in the tooth or a filling that is failing could cause discomfort. It might also stem from the pounding the tooth takes from opposing teeth during regular chewing or in grinding (bruxing) at night. In either case, follow-up tests should be done to determine the actual cause of the pain before a treatment plan is suggested.
The dentist should also properly record the discussion for later review, in case the treatment is postponed.
- Is there anything you will need to do to ensure that the treatment will be effective long term? Ask yourself if you will be able to carry out the requirements.
- Have you been given a prognosis (a prediction of success of the treatment over time)? If you decide to go ahead with the treatment, what should you expect in the long term (ruling out accidents and unforeseen problems)?
- Finally, have you checked with friends and online sources to see how your new dentist is rated by others? Trusting your dentist is the first step to a successful experience.
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2019, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1 [GO_FHcd18]