When we think of the implication mindset, Dr. Dawson has talked to us for a long time about a way for us to think about dental problems and approach to dental treatment as a way to communicate with our patients and help them move forward with their treatment. One way to look at it is, when we find dental concerns in a new patient exam, we speak to our patient in terms of 'is this urgent?'
Urgent vs. optional
Is this urgent or is this optional? For example if it's urgent, is there infection? Is there pain swelling, a sharp edge, something that really needs immediate attention? That has to be, obviously, taken care of right away.
Important, would be things like wear. It doesn't hurt right away, but we can see it's a big issue or also older amalgams. That kind of a thing.
Something that is optional would be something like, 'Would you like to whiten your teeth? Your teeth are healthy, the gums are healthy, so whitening is totally up to you.' That would be an example of optional, picking color. A lot of times when we think of this, we're trying to explain to our patients in terms that they can understand.
Understanding the implication of deferring treatment
To bring up an implication would be, for example, a severe wear case. The patient may or may not be concerned with it or even aware of it, but we have pointed it out to them in their co-diagnostic exam; we've brought this up as a concern.
One of the ways to bring up an implication mindset would be, "one treatment option that we have is actually to do nothing. What would happen then?" And if we ask the question, the patient might say, "Well, it's going to get worse." Exactly. And so we can go down the pathway of what does worse mean for them, how it affects their life. We have to put it in terms that they can relate to, not so much technical dentistry.
Another one that we see a lot is older amalgams. They're not painful. They've been in there for years. Why would I do anything with it? The implication is we can show them photographs of cracks on the marginal ridges or chipped or cracked fillings.
Understand their risk profile
We can imply that this is just going to get worse, and there's going to be a bigger problem down the road. At that point, you're also learning your patient and how they respond to you by basically their risk profile. How averse to risk are they? For some people, if you show them a crack in a molar, they immediately think, "Well, this could break at any moment, and I want to get it fixed tomorrow." And we've had other people tell us, "When it breaks, I'll call you." Both of those are right answers for that particular person because we're trying to figure out where this fits in the patient's life.
Be an advocate and give patients all options
What happens at the end of that is you are not a pushy salesman. What the patient perceives is you are their counselor. You're their health advocate, and you're on their side. You're giving them options, including doing nothing.
They are very appreciative of that advocacy approach. And they refer their friends to somebody who's not really going to try to push something on them, which they may have experienced in the past. The implication mindset is a wonderful approach and will hopefully be helpful to you.