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Navigating Treatment Failures and Dentistry’s Unique Challenges
17 Plays3 days ago
About the Hosts:
Dr. Craig is a vibrant, newly graduated dental professional who is making her mark in the world of dentistry. With a keen focus on continuous learning and adapting to challenges in her practice, she shares her journey of navigating the complexities in dental practice during the early years of her career.
A seasoned dentist, Dr. Sartor brings a wealth of experience and wisdom to the podcast. Known for her insightful perspective on patient communication and dental efficacy, she offers valuable strategies and methodologies for successful dental practice management. Her journey reflects growth and adaptation to various industry challenges.
Episode Summary:
Welcome to "Beyond Graduation," where Dr. Savanah Craig and Dr. Ronnetta Sartor explore the nuances of early career challenges in dentistry. In this episode, they delve into the critical and often controversial topic of handling treatment failures and rework in dentistry, comparing it to practices in medicine. This engaging dialogue brings forth the intricacies of patient communication, professional accountability, and building a successful practice.
Dr. Craig and Dr. Sartor exchange perspectives on how newly graduated dentists can navigate reworks, redo procedures, and treatment failures. They discuss the importance of transparency with patients and how to manage expectations amidst the unpredictable nature of dental treatments. Dr. Sartor reflects on her own maturation process in the dental field, sharing strategic insights into over-communicating with patients to align their expectations better.
In examining the broader aspects of dentistry that set it apart from medicine, the episode explores how dental insurance and the perceived value of oral health influence the coverage and expectations surrounding dental procedures. Dr. Craig candidly discusses her sentiments as a new practitioner, grappling with imposter syndrome, and emphasizes the role of ongoing education and honest communication. The episode highlights the shift towards viewing complications as educational opportunities, where the "dentistry failed, not the dentist," fostering a supportive environment for professional growth and patient trust.
Key Takeaways:
- Differences in handling treatment failures and reworks are stark between dentistry and medicine, prompting reflections on accountability and patient communication.
- Establishing a robust dialogue with patients about current and future dental risks plays a vital role in managing expectations and outcomes.
- Newly graduated dentists like Dr. Craig explore balancing personal accountability with unpredictable complications in dental procedures.
- Reflecting on a transition in mindset, from personal blame to recognizing systemic failures in dentistry, enhances learning and professional development.
- Understanding how patients value dental health compared to general health systems can influence discussions and expectations regarding treatment outcomes.
Connect with Us:
- Savanah Craig, DDS: @savanahcraigdds
- Ronnetta Sartor, DMD: @dr_sartor
- FutureDentists Beyond Graduation: @futuredentistsbeyondgraduation
- FutureDentists: @futuredentists
- IgniteDDS: @ignitedds and @ignitedds_coaching
- A-dec: @adecdental and https://www.a-dec.com/find-a-dealer
Embark on this enlightening exploration of dental practice management beyond graduation by diving into the full episode. Stay tuned for more insightful discussions and valuable strategies that promise to enhance both your professional journey and personal growth in the field of dentistry.
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Transcript
Introduction and Smart Start Program
00:00:00
Speaker
ADEC's Smart Start program offers first-time practice owners their deepest discounts on equipment and furniture for two years, plus other savings and complimentary services. Ask your ADEC rep for details and start smart with ADEC.
Podcast Focus: Life Beyond Graduation
00:00:13
Speaker
Join Drs. Savannah Craig and Renetta Sartor as we navigate life beyond graduation. Real conversations about forging our own paths in our early years in our careers.
00:00:24
Speaker
There's a reason it's called practicing dentistry. Welcome back to another episode of Beyond Graduation. i am Savannah Craig and with me as always...
Rework and Redo in Dentistry vs. Medicine
00:00:33
Speaker
am Renata Sartor.
00:00:34
Speaker
We are happy to be back. This week we are talking about, i don't know, would you is it controversial? is it ah hot topic?
00:00:45
Speaker
How... How to describe it? So this one came up, another look inside our ever-growing text thread.
Matured Perspectives on Treatment Failures
00:00:53
Speaker
But this idea of dentistry, i don't the way we present our like reworks or redo or treatment failures, all of these are various words to describe the differences in how we look at re rework, redoes in dentistry versus medicine and how this has changed.
00:01:15
Speaker
This perspective changes over our career or personally day to day or an hour to hour, how I'm feeling. But Renetta, share with us your thoughts. I think you've matured into into a different perspective over your career. so are you Are you calling me old?
00:01:35
Speaker
Maybe. Maybe, just a little. Wise, mature. Seasoned. Seasoned. This is a great topic.
Case Study: Broken Tooth Dilemma
00:01:43
Speaker
And I think part of what's sprung it is, i think you sent me a social media post.
00:01:48
Speaker
And there was a post in which a dentist was doing work on one tooth and a tooth that they had spoke with the patient about right beside it broke during the process of taking the tooth out.
00:02:01
Speaker
And, you know, the question was posed, you know, do... you charge for the work on a tooth that broke while the tooth, the other tooth was coming out.
00:02:13
Speaker
And so it just kind of sparked conversation on social media, but then outside of social some social media, Savannah and I talked about it. And so when Savannah and I were talking, I was
Importance of Comprehensive Exams
00:02:25
Speaker
like, well, i think earlier in, in dentistry, in my career, my thought process was, well, if it broke,
00:02:35
Speaker
while I was taking out the tooth, then it must have been something that I did. And so if I did it, it's like, if if you break it, you buy it. And that's how I thought about it.
00:02:47
Speaker
right So over time, I have evolved in you know my comprehensive exam. And so my first time ever meeting a patient that has a comprehensive exam, I'm looking at everything and telling them,
00:03:05
Speaker
Anything that I see that's currently a problem or anything that may be a potential problem in the future with their permission. If I don't have their permission, I'll just simply say, hey, there are some things going on in your mouth that has me concerned. Whenever you're ready to talk about it, I'm here and I'd love to have a conversation with you about it.
Patient Accountability and Communication
00:03:27
Speaker
And so early on, i like to plant the seeds that, okay, there are things going on that will need to be addressed in the future. And I think in doing so now, if I have a tooth that had some issues, were taken out a tooth, I think there would have by that point been multiple conversations or references to this tooth that,
00:03:55
Speaker
being at risk to where I would not feel like if I break it, I buy it or feel that I broke it, you know, yeah to have to buy it, you know, it will be more so a conversation. Okay. Hey, you know, we talked about this tooth, you know, it's not looking good.
00:04:15
Speaker
We need to go ahead and move forward doing treatment on that tooth or, you know, if the patient at that time doesn't want to, we talk about w risks associated with no treatment. either.
00:04:26
Speaker
What are your thoughts? Where you are? Where are you right now? And are you, are, are you the, if I break it, I buy it right now? Probably lean more that way. I'm trying to get out of it.
00:04:39
Speaker
couple of factors, I think, cause I've been thinking about this a lot since we've been texting. I think the more dentistry i do the more mouths I look at, the better I'm getting at seeing those potential problems.
00:04:51
Speaker
And bringing it up. Or at least like you said, planting the seed that there are other concerns brewing in these areas. So when I do that, I feel better about charging for treatment that is needed additionally.
00:05:07
Speaker
Sometimes you don't know what might happen to the tooth next door and... I think a lot of this is just because I'm so new to dentistry, you don't you don't always know the possibilities. So that's one one reason i think I'm more prone to try to smooth things over.
00:05:26
Speaker
to play sort of devil's advocate, we are in just a world of... Google reviews and litigation and as a society, we're more prone to, I don't know if anger is the right word, but blame maybe. it's it's hard for some people to take responsibility and trying to give that responsibility to the patient and not to you.
00:05:52
Speaker
Sometimes, honestly, I'm just like, i I just don't want to deal with the potential repercussions and I will eat the whatever lab cost of this crown and my time to smooth it over. And maybe that's not the right perspective to have, but there are, and that's what I mean by day to day, it changes and different patients and different things like that. But ah genuinely there are times where just like, whatever, I'll just do it. And I probably not always the right answer, but sometimes I just want it to be over.
00:06:19
Speaker
Yeah. I think it's time and place
Over-Communication and Managing Expectations
00:06:21
Speaker
too, right? Yeah. think- The more, you know, the in your words, the more old or more seasoned I get in the profession, the more I learn the importance of over communicating with our patient. So if during that comprehensive exam, or let's just say it's a limited exam and a patient comes in on one day just for an extraction.
00:06:45
Speaker
yeahp And I look around and I say, I see that there's a lot of recession. There's a lot of decays, a lot of stuff. I plant the seed then. But let's just say you mentioned a crown remake or something like that, right? right Let's just say that, you know, patient came in before the crown was needed and we see there's a lot of erosion in the mouth.
00:07:08
Speaker
We see that they have dry mouth. We see that there are on a whole lot of medications and all these things, we're going to have a discussion about, okay, here are all the things that's putting you at higher caries risk.
00:07:25
Speaker
Here are some of the things that we could do to mitigate it. And as you know, there may be some situations where, It's an uphill battle and we may never be able to help with the xerostomia that's medication induced.
00:07:42
Speaker
You know, all we can do is try to slow it down. Yeah. I think that's a discussion that should be had with the patient. And if that crown that's needed on that tooth fails, it's the patient should have some accountability in that too, if that makes sense.
00:08:05
Speaker
Like it's not, it's more so like making a transition now. Don't get me wrong. There are some situations where I'm like you, okay, I'm going to honor my work. If a crown broke and it's because I had under reduce that's on me.
00:08:22
Speaker
Sure.
Accountability for Procedure Failures
00:08:23
Speaker
Yeah. I'm going to remake it, you know? Right. Or, hey, this margin isn't as good as I want. We're sending it back to the lab. right. Or if, you know, I do a composite restoration and I'm in hygiene and I see that I don't like how the margin looks or there's an air bubble in it, I'm going to redo it at no charge to the patient.
00:08:43
Speaker
You know, apologize to them. Tell them all I need is their time and I will make it right. But if it's a situation like what we talked about, you know, a lot of it is the more you over communicate, the more, not that you won't have any pushback you know but I think it becomes less of a thing because when things happen, patients remember, oh yeah, I remember you told me that. Or i know in a previous episode, we talked about documentation.
00:09:14
Speaker
Yep. And your oral photos. And now we have scanners where we could take a scan and compare it to what it looked like six months ago and, you know, let our patients know, hey, it's is breaking down.
00:09:28
Speaker
this is what it looked like six months ago. This is what it looked like today. We need to do something. And documenting the conversation in your clinical notes as well.
00:09:40
Speaker
Because if it is not in your note, it did not happen. Very true. What about, I'm going to play devil's advocate here. You over communicate, you talk about all the risks. Okay, first of all, you cannot talk about all of the risks.
00:09:54
Speaker
Okay. Do you know what i mean? If you did, nobody would do anything ever. two I don't always know all of the risks. Weird things happen sometimes. And three, people don't always listen to me when I tell them everything.
00:10:09
Speaker
What are you doing in those situations? Because for me, sometimes I'm just like, I know that I told you. You're going to fight me. Or i don't know why this weird thing happened, honestly, because I have only been doing this for two years.
00:10:22
Speaker
and And honest communication in those moments. But sometimes it's just like, here's your refund and let me get you in the hands of somebody who can help you better than I can. And I think nothing's wrong with that.
00:10:35
Speaker
Yeah. You get what saying? if If there's a disconnect and I'm not getting through to you or if the patient's communicating with me and they're not getting through to me, then you're right.
00:10:50
Speaker
it's so It's okay to give that refund. Because I mean, over time I have learned that too, right? Like, you know, if there are red flags there or if we're just constantly not on the same page,
00:11:05
Speaker
Overall, I care about my patients and their health, whether it's their oral health or, you know, just overall systemic health. Right. And so I want them to get the best care possible, even if I'm not the person that they're getting it from. Yeah.
00:11:21
Speaker
Yeah. So at some point, I think you're right. You have to make that call, you know. Yeah. I think – why do you think dentists do this?
Comparing Patient Expectations: Dentistry vs. Medicine
00:11:32
Speaker
Because medicine doesn't do this refund thing. Even if even if you – I have a patient whose family member had like a knee replacement – and it became horribly infected, and they've had to have all of these revision surgeries. And, i mean, there were talks of, like, potentially, like, amputation and things just because of how bad this infection had spread.
00:11:59
Speaker
And that's just a freak thing, right? And I tell patients this all the time, like there are just risks and complications to everything, but especially healthcare that even that we just can't even plan for.
00:12:14
Speaker
But in dentistry, we take that on ourselves and I don't know why we do it. Yeah. I'm not sure. I'm honestly not sure. It's a very, it's a very good question.
00:12:25
Speaker
so To pose, you know, like I think a lot of it too is being honest with ourselves and being honest with the patient, right? I can go to all of the CD in the world, right?
00:12:38
Speaker
But I don't think I'm ever going to be able to replace something better in form or function than what a patient originally was given by God or whoever we may believe in, right? Sure.
00:12:53
Speaker
You know, I'm not God. Like, i you know, i i I can only do but so much. And I think part of it is you know, having that conversation with patients about expectations, you know, and over communicating that too. Would it bring, you bring up a very valid point. Like if we do a filling and the filling breaks, some of it might be the difference in medical insurance versus dental insurance. Right.
00:13:23
Speaker
And so we know that if a filling needs to be redone, insurance is ah isn't going to pay for it on average. Yeah. Yeah. But every five years or something like that, right?
00:13:35
Speaker
Yeah, good point. And so it could be that as dentists, we're like, you know, we want to honor our work and we just eat that cost, you know? I wonder if part of it too is just, I don't know if education is the right word or the public, you know, if you need a hip replacement, right? but you don't always know that you need a crown.
00:13:59
Speaker
Yeah, I think you bring up a very, very, very good and important point. I think it's value, right? Yeah. If I'm in so much pain that I cannot walk, that's greater value than getting a crown put on a tooth.
00:14:14
Speaker
Right. Because I'm likely still, for the most part, able to eat. Right. Right.
Societal Perception of Oral Health
00:14:18
Speaker
I'm able to function still. So I think a lot of it is i think we still live in a time where oral health is not valued as much as like systemic by society.
00:14:33
Speaker
You know, for example, like sometimes we'll be the only health care provider that some patients will see. If they're coming every six months, we'll see them more frequently than other people.
00:14:45
Speaker
yeah it It goes back to like the the mouth being a gateway that it shows what's going on with the rest of the body. But I think in general, some people still think that the mouth is ah aside from the body.
00:15:01
Speaker
Yes. You know, and it's not all connected. Yep. What do you think? No, i I definitely think as a society, we've separated. I mean, medical insurance and dental insurance are separate.
00:15:13
Speaker
Our schooling is separate. We just believe it's separate. But also teeth are weird in that, like, think of a necrotic tooth. It hurts and then it stops hurting. That's true. and so And sometimes teeth get sensitive, right? And they hurt for a little while and then they stop and they're totally still fine.
00:15:33
Speaker
But then other times my tooth hurts really bad and then it stops hurting and that's because it's dead and infected. And teeth are just weird. it saw this video on Instagram today about...
00:15:44
Speaker
There was some song about how teeth are the bones outside your head. And it was just like this whole comedy thing. And I was like, they're super weird when you think about it. Like the existence of teeth, but then also just like the nerves.
00:16:00
Speaker
So I think they're an enigma to people too. Yeah, because think about it. Enamel, right? For example, is one of the hardest surfaces in the right?
00:16:12
Speaker
surfaces in the body right However, however, it once it's gone, it's gone. Like we can't grow it back for you.
00:16:22
Speaker
We can do some work for sure. But you know, we can't grow back. Yeah, it's the other thing that I think is so hard is, and medicine as a whole, I guess, is this way where we are spending less and less time with patients just because of the way things work.
00:16:40
Speaker
But trying to explain everything that I know in here in a way that resonates with people, makes sense to people, and discusses all the multiple factors going on here is really hard. And again, sometimes I don't even know.
Dealing with Imposter Syndrome
00:17:00
Speaker
so i think I think it's so easy to take that responsibility on ourselves as the dentist. And i was having a conversation with ah a classmate and good friend of mine about me personally, i am prone to imposter syndrome and immediately assuming, oh I didn't do good enough here.
00:17:20
Speaker
And trying to get over that in my own head because I'm sure whether I know it or not, the way that I talk to my patients has that in it.
00:17:31
Speaker
You know what i mean Whether I mean to put that out there, there is that bit of intention in my own brain. And so I think the more that you practice and the more that you see your work, the more you know – where that responsibility lies, I guess, is – Yeah.
00:17:47
Speaker
I think one of the – I think i maybe was where you are right now out of school – And I went to a lecture and it was Dr. Leanne Brady. We love Leanne Brady. I know. And she had a lecture about like complications in dentistry. And one of the things that she has said that has stuck with me to this day is that we have to start realizing that the dentistry failed. It's not that we failed.
00:18:17
Speaker
And so like it's one of the things that still resonates with me. And I think piggybacking off of what you said earlier to about like how do you communicate it to the patient in a way that resonates with them. And this is Dr. David Rice.
00:18:32
Speaker
He always talks about knowing what our patients value and what's important important to them. if someone values spending time with their grandchildren they have a vacation with their grandkids coming up, well, you don't want that tooth to start hurting you while you're on vacation.
Understanding Patient Values and Effective Communication
00:18:51
Speaker
let's try to get it taken care of so that you can spend the time that you want with your grandkids. And it's not saying that in a way that makes someone feel bad for not doing treatment, but it just says it in a way of that makes them think, oh, you know what? I do value that. And I don't want to have to call you to hope that you could get to me when, you know, I'm in crisis. If that makes sense. Absolutely.
00:19:18
Speaker
Absolutely. I don't know, this is a really good topic. We could probably talk about it all day, really. Absolutely. yeah I would love... comments and thoughts from people because i do think I do think this is a hot topic in dentistry. And it's definitely a situational thing as well.
00:19:36
Speaker
Like I don't think you could blanket and say, I never. yeah I definitely can't say that. i definitely can't say that. I never because I think certain situations, you know, I i would and I would honor certain things.
00:19:51
Speaker
But I think it has been something, you know, it has to be something where i'm like, yeah, I can see that. Yeah, but I'm gonna tattoo the dentistry failed, you didn't fail across my forehead. i think we all need to though, because we we take it personal.
00:20:06
Speaker
I think we should circle back to that at some point, because I do wonder what in our like dental education or whatever... but that put that into us, but we could talk about this forever.
Listener Engagement and Final Thoughts
00:20:18
Speaker
So friends, let us know your thoughts on on this topic and what you do in your office and when. And yeah, the dentistry failed.
00:20:28
Speaker
You didn't fail. Until next time. you for joining us for this episode of Beyond Graduation. If you enjoyed this week's episode, be sure to share it with a friend. Connect with us on social media at Savannah Craig PBS and at Dr. Underscore Sartor.
00:20:45
Speaker
And remember, you are not alone on this journey. ADEC certified pre-owned equipment is a sustainable, affordable choice that makes genuine ADEC equipment available to every doctor. Each package is sold on a first come, first serve basis. So if you see one you like, contact your dealer. For more information, go to www.adec.com backslash findadealer. Thank you for listening to Beyond Graduation brought to you by Ignite DDS and Future Dentists. This episode was sponsored by Ignite DDS Coaching. We build self-determined futures. For more information, please reach out to the Ignite DDS team.