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How do you bring up occlusal issues during recall visits?

This video is an excerpt from the April 2015 Dawson Faculty Office Hours with Drs. Leonard Hess and Rajeev Upadya. To watch the full office hours and to sign up for future office hours, visit the Videos and Webinars page

The following is a transcription of this video excerpt. 

Question: Your new patient either has a joint/muscle/wear issue that needs to be addressed or they are in an ideal relationship/or have a system that is working, but isn't ideal. How do you delineate those patients in your practice during recall visits?

Dr. Rajeev Upadya: This is a really common thing, especially with a legacy practice or a practice you've had for quite a while; you have patients coming in on their regular recall schedule and you start noticing the things that you maybe had overlooked before. One of the great thing is this is an opportunity to have an open conversation, a way to start having a dialogue maybe with a photograph and begin discussing some of the issues in a non-confrontational, non-pushy way. Usually in my office, this opens the door to start the conversation. 

I start discussing a few of the issues and if the patient seems engaged and wants to take that discussion further, we go on for a few minutes. If the patient looks like they want even more answer, I say, "Hey, let's set aside a little bit of time when we can study your case some more and look at some of the changes we've seen over the last couple years occur for you and see what our possible solutions are." That patient basically becomes a records or new patient at that point.

Dr. Leonard Hess:  That's great. One of the things we have to remember, as we are in General Dentistry practices, we are going to have two pools of patients; we are going to have our General Dentistry patients on one side and our Complete Care patients on another side. We are always going to be having a flow from the General Dentistry side into our Complete Care side.

What your'e going to find as your practice evolves, you're always going to have patients in a constant state of flux; meaning you may have patients with signs of instability (wear, migration, mobility or maybe they're having joint issues), but not everyone is always ready to jump into that Complete Care side.  

So what we're doing in my practice for those patients that have signs of instability that need to be addressed and haven't been addressed yet, we give them gentle reminders and ask questions about signs and symptoms they may be having and waiting until they're ready to transition into the Complete Care side. 

As you progress through this transformation in your practice, you're always going to be having a give and a take and a pull and a give as your patients start to understand the long term implications of what's happening in their mouth and their system until their ready to start addressing that.

Like Raj said, that is a great question and we hear it a lot.