I check my splint patients at their hygiene appointments. Imagine how I felt when I asked a patient if she was wearing her splint, and she said “yes,” and when I asked to see it she handed me her old orthodontic retainer.
She looked up at me and said, “Oops, you caught me.” She hadn’t worn her splint in a long time, because she didn’t feel she needed it anymore. Somewhere along the line my message didn’t stick.
That’s not the first time a splint patient either stopped wearing their splint, or lost the splint, or maybe even fed the splint to the dog. It’s the same feeling I get when a perio patient goes back to the same bad habits that caused their disease in the first place, or I find out that their very expensive partial denture is lying at the bottom of their night table drawer.
The consequences for the patient are pretty grim, but for me I feel as if I am not doing my job because I place a high emphasis on doing meaningful work.
The key to meaningful work is to gain commitment from the patient.
Dentistry that changes people’s lives isn’t, and should not be restricted to, cosmetic dentistry. Changing people’s lives in meaningful ways is about health, comfort and function as well. Function is the one that lies under the radar. Function is the one that requires more education, and splint therapy is the educational and motivational tool.
Let’s face it when people enter into comprehensive dental treatment some level of commitment is necessary in order to get the best long-term benefits. People weigh the benefits of treatment against the consequences of treatment…the result is the level of commitment. When the benefits far outweigh the consequences…the cost, the time, the levels of discomfort, real or imagined…then there will be commitment.
And the work will be more meaningful for all.
Many cosmetics dentists use a technique called a trial smile or cosmetic mock-up. The purpose is to show the patient the benefits of cosmetic dentistry. In sales they call that demonstrating the solution. You see demonstrations on TV all the time. The famous pitchman Ron Popeil would wow viewers with demonstrations of his Chop-o-Matic hand food processor or his Veg-o-Matic slicer.
Think of a splint as a way to demonstrate to the patient problems they never knew they had. They will accept your splint like people accepted the Pocket Fisherman. Just kidding of course. The point is that dentists need to educate patients when they are not aware of the problem.
People will never accept a solution to a problem they don’t understand in their own mind. Many will nod yes because of the positional authority of the dentist…only not to follow through with treatment or put the partial in the drawer and never come back.
Here are a few guidelines for using a splint as an educational and motivational tool:
- Splint therapy can be the gateway for patient’s accepting long-term comprehensive dentistry. Become an expert in diagnosis and splint treatment options.
- Take the time to educate the patients as part of your new patient examination process. Make sure they thoroughly understand the problem before treatment is presented. Make use of photography, muscle palpation, diagrams, TMJ trainers, and of course mounted study models.
- Relate your findings to any signs and symptoms.
- If they do not acknowledge a problem…don’t treat through the occlusal issues.
- Once they own the problem…the splint becomes the ultimate demonstration. The next natural question for them is “where do we go from here?”
- Slow down the examination-presentation process.
I started this post with a description of the uncommitted patient, but in reality nothing, except maybe cosmetic mock-ups and pulpotomies, has done more for educating and motivating patients than splint therapy.
That’s how you can continue to do meaningful work that patients thank you for.
How do you use splint therapy for education and motivation? Leave your response in the comment section.
Great Post! For me the Splint Therapy has been very useful for two purposes. The first one is related to preparing both the patient’s muscles and joints prior to the provisionalization process. The second purpose is the one related to the motivation aspect. Once you have diagnosed properly from the start the splint therapy can be a tremendous educational resource. It speaks for itself. It gives the patient the perception that there’s much more involved than teeth. It gives the patient the notion you’re in the right path. For some of those patients the splint and the dentist become their best friend. Thank you Dr. Polansky for sharing your communication expertise with us through your TAO posts!
Comment by Frederico — October 17, 2014 @ 8:41 AM
Pankey spoke to the issue of knowing your work…technical and behavioral. Splint therapy is where the two truly come together…body and mind. Add in meditation and you have body mind and spirit.
Dentists are mostly concerned with diagnosis and treatment to fill in their knowledge gaps…but those that study the whole person truly thrive.
Comment by Barry — October 17, 2014 @ 12:32 PM