Need These Teeth Fixed Yesterday

Being a good dentist is about listening to my patients and giving them what they want. But, there are also times when I must refuse to do what my patient wants. This is a story about one of those times when I said “No” to a patient’s request, contradicting the views I expressed last time. Read on to learn why.

A few years ago, I walk into an exam room to see my last patient for the day. This gentleman, complete with a cowboy hat and boots, was in for a consultation. 

He tells me that he does not like how his teeth look and wants them fixed right away with veneers. I ask him what he meant by “right away”- did he mean right then? My brain is already calculating how long it’s going to take and that my daughter, as is the case most days, will likely be the last kid to be picked up from her after-school care. He says, “I mean like I wanted it done by yesterday ma’am, that’s how fast I want it to be done”. Now this really piques my interest and calms the ticking clock in my head. He goes on tell me a back story. He has never liked his teeth, especially his upper teeth but he has never found the time, nor the interest to do anything about it. Money is not an issue but now he is at a significant stage in his life where he wants to take care of himself. He flat out told me that I am the second dentist he came to get a consult and that as a business person he always gets three quotes. So, there is another doctor in line after me. He said “I want veneers for my teeth”.

In my clinical judgement he was clearly not a good candidate for veneers because of his bite. Veneers are a great option in many cases, but not for him. Don’t worry, I am not going to bore you with all the dental specifics. So I tell him, that even though finances are not an issue for him I would not do veneers in his case even if he paid me double the fee. He looks kind of shocked and I proceed to give him two other options to get straight white teeth like he wanted. One is the most conservative approach but would take longer time with less preparation on his teeth and other would be more aggressive on his teeth but with faster results. None of these options had veneers in them but would give him the same results with long term stability. I leave the operatory to go to the front office and give them info to get the two treatment plans on paper. While I was there, I see the gentleman walk out of the office in a huff. I realized that the patient didn’t like what he heard from me and just walked out, so we scrap the idea of putting together the treatment plan and I go back to my office to leave for the day. In a couple of minutes my office manager comes to me and says that the patient is back and wants to talk to me. So I go back and he asks me to go over the options again. I explain in great detail about the risks, benefits and alternatives associated with both options that I proposed. He leaves and comes back to the office the next day with no appointment, wanting to meet me briefly. He then tells me that he cancelled the appointment with the third dentist and wants to start the treatment with me.

The reason he came back was that he was happy about being given options and understood what he was getting into. He chose the route of doing the second option with faster results but more work on his teeth knowing fully well the risks associated with that course of action. By the time, we reached the tail end of his treatment we became good friends. I would always joke around with him about how he addressed me as “ma’am” though I was younger than his daughter. He was extremely happy with the result but I’ve got to say-- a lot of credit goes to him for following all the instructions to the T. I respect him a lot for starting a new oral hygiene routine and sticking to it at his age. It’s never too late, as they say.

The take away from this story is: as a patient, you should always ask about and know your options. There may be situations where you have no options or when your options are limited, but you owe it to yourself to ask. Also, understand the risks, benefits and alternatives associated with each procedure. Be informed, educate yourself and try to get the information from your dentist, instead of going online. The internet has a lot of conflicting information and a lot of what you read may describe an unrealistic or unlikely scenario. Just as you would have a medical procedure done based on your doctor’s recommendation and not online collaboration, extend the same rationale and courtesy to your dental needs as well.

Only brush, floss and waterpik the teeth you want to keep.

My best always 

Dr Vijaya Tippireddy 

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