“Maybe he’s sneaking things you don’t know about.” The dentist was referring to my three year old with at least four cavities. That was his response when I asked him what I could be doing to prevent future cavities. I explained that we don’t have soda in the house, we rarely have juice, and candy is always soon followed by tooth-brushing. I called my friend, also a dentist:
“It sounded so condescending!
Am I over-reacting? Is this normal?
I mean, really, look at my teeth – and Jacob’s teeth –
does it look like we don’t take care of our teeth?!”
My friend said to start from the beginning.
I brought Max in to see our family dentist when he was two years old; I noticed dark spots on two of his new baby teeth. Yes, they were cavities. When I asked what else I could be doing, his answer was “you need to be more consistent about brushing & flossing.” I was a little defensive, but I thought maybe he could be right, so after getting those two cavities filled I buckled down on tooth brushing in our house. Six months later the dentist proudly proclaimed “no new cavities!” and put Polaroid pictures of both boys on the “no cavity club” board in the waiting area.
Six months after that, Max was three and I was brushing his teeth in the evening. I saw a big hole in one of his new top molars. I called right away to make an appointment and that’s when the dentist suggested that my three year old was “sneaking stuff.” My friend asked “what did the x-rays show?” “He didn’t take x-rays yet; he said he’d take them at our next appointment, just before he filled a couple of the four to six cavities he thought he saw.”
“He didn’t take x-rays so he’d know ahead of time what he was going to do?” She tried to hide her disappointment; it’s a small town and all the dentists know each other.
My friend is a professional and didn’t want to speak badly of a colleague. I saw right through it.
“Let’s make an appointment for a consultation. I’ll treat for the consultation and you can pay me for the x-rays.” She found EIGHT cavities in my baby’s mouth. “Some kids are just susceptible to these bacteria. I’ll send you home with prescription toothpaste, we’ll fill these cavities (one required a steel cap), and follow up in six months.” Max hasn’t had another cavity in almost ten years.
I called the other dentist to have both boys’ records sent to my friend across town. I offered to give feedback when the assistant asked why we were leaving. I suggested the dentist call me so we could talk about my concerns about the treatment. He never called. I never went back. The whole family switched dentists.
Patient: Condescension is never ok. Forget the fact that when the dentist looks at you, he or she may have preconceived notions based on your appearance and possible education level. If your doctor is condescending, either call him or her on the bad behavior, or find another doctor. If you think something is wrong with treatment, don’t just trust the person because he or she is the doctor. Get a second opinion! You must advocate for yourself and your family. I waited too long to call for a second opinion and my son’s baby teeth suffered for it. Don’t let that happen to you.
Dentist: Condescension is never ok. You may have preconceived notions based on your patient’s appearance and possible education level; don’t show it. If a patient asks for ideas, don’t stop at “you should be doing this better.” Ask for details to find out if more aggressive treatment is necessary. If you don’t have a good answer, FIND ONE. There are so many resources available to you with the click of the mouse. Use them to improve the lives of your patients and the success of your practice, no matter how many years you’ve been doing it. And most important in this story; when a patient offers to provide feedback in a calm and constructive way, TAKE IT! Not only did my dentist lose our family as patients, he lost my respect and the possibility that I'd recommend him to anyone with children.