Whatever the reason for refusing treatment, we must understand that patients do have the right of refusal. Other patients mistrust us because we have not earned their trust with excellent patient service. Some of our patients are so busy with their work that they don’t see how they can find time to address dental care. Some of our patients have been through unpleasant experiences in other dental practices that have left them mentally “scarred” toward dental treatment.
Other reasons for refusing definitive treatment include fear, inconvenience, and mistrust. We can and should offer our patients ways to finance their care through good companies such as CareCredit, and help them overcome the financial barrier to good dental care. When people struggle to pay for housing, transportation, food, clothing, and medicine, dental care might be restricted to emergency only. Patients refuse treatment for a variety of reasons, but one of the main ones is finances. Further, as the job situation continues to deteriorate and more people lose their jobs along with dental benefits, the scenario of people refusing definitive periodontal treatment is expected to worsen. The problem you describe is in every dental office in America, and it is a regular occurrence in some offices. How can we help people who refuse our treatment recommendations? Nevertheless, I don’t want to be guilty of fraud. This speaker further suggested that we dismiss from the practice any patients who refuse to submit to our treatment recommendations. We recently heard a risk management speaker say it was outright fraud for hygienists to do a “prophy” in the presence of disease. Follow up – this ten teeth dental bridge has been stable for nine years since this procedure.The current dilemma in our office is the number of patients with signs of periodontal disease who refuse to have periodontal treatment. It is possible that earlier diagnosis and intervention might have prevented the loss of this tooth. Patients need to be acutely aware of the need for frequent recall visits. It is suggested that oral reconstruction patients are treated, not cured, and that they must be closely supervised. The periodontal abscess was readily apparent at this time. This patient was scheduled for a three month recall she did not return for eight months following her first three month recall visit. The roots of this extracted tooth were fused. 4) Following root planing, targeted antibiotics and tooth extraction. 3) Gutta percha placed into a periodontal abscess one year later.
2) Following root canal therapy, root planing and open flap periodontal debridement. These radiographs x-rays show of a failing distal tooth abutment in a one year old ten teeth dental bridge. An evaluation by the Periodontist and recontouring of the laminate veneer margin will occur following resolution of the acute condition. 4) Reevaluation two days later showed improvement in symptoms, gum pain relief and gingival inflammation. The patient was put on tetracycline antibiotics for a week. It stayed at the coronal gingiva gum around the margin of the laminate veneer. 3) A gutta percha point was placed in the fistula gum boil and radiographed to see where it went. 2) The x-ray of tooth #9 shows a healed apicoectomy from 12 years ago that is not related to the current problem.
Her general dentist had performed a gingivectomy – minor gum surgery – last year to attempt to treat the occasional swelling of the gums in this same area. Tooth #’s 8 & 9 had acrylic laminate veneers placed about two years ago by her local dentist. 1) This patient presented with this gum fistula between tooth #’s 7 & 8. Acute periodontal abscess that caused swollen gum pain.
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