Seeking magical incantation to make my dentist take me seriously
January 11, 2016 8:45 PM   Subscribe

Twice this past year, I've gone to my dentist to check on some unusually concentrated sensitivity + discoloration in spots on my teeth, and twice I was sent home in 5 minutes with a little sample of Sensodyne. Today I had a regular cleaning/check-up, where she found decay in (surprise!) exactly the spots I pointed out previously, and admonished me for not coming in sooner (my dental plan only covers annual visits). Next time this sort of thing happens, how can I be firmer about getting things checked more thoroughly?

In the moment, I was a little peeved but unable to really articulate it without sounding petulant, so I just politely made my appointments for my future visits and left. I have some anxiety about expressing my needs to healthcare providers, but I have had a truly absurd number of fillings over the years -- I certainly know from cavities. Of possible note is that all of the problem spots were apparently identified through the x-rays, which are done yearly regardless of frequency of other visits. Thoughts?
posted by btfreek to Health & Fitness (15 answers total) 4 users marked this as a favorite
I would find a new dentist, immediately!!

One who listens to your concerns and keeps better records of your visits/history. They're out there. I've had to shuffle through a handful before finding an excellent one in every town I've moved to.
posted by slateyness at 8:56 PM on January 11, 2016 [28 favorites]

Is there a good reason you're sticking with this dentist? Or are you asking more generally about how to be more assertive with healthcare providers?
posted by dondiego87 at 9:06 PM on January 11, 2016 [1 favorite]

I don't know the correct terminology - my French Canadian dentist calls them "spots" - but it's within the spectrum of appropriate care either to try to re-mineralize these and avoid a future cavity, or to drill immediately. But the treatment plan needs to be understood and mutually agreed upon by the patient and dentist. If that hasn't been your experience, find a new dentist.
posted by mikek at 9:11 PM on January 11, 2016 [3 favorites]

I also recommend finding a different dentist. Feeling judged by the doctor always sucks, and it stings even more when you were trying to heed her advice and are limited by your insurance. There are a lot of great dentists out there, professionals who won't scold you for your financial limitations and/or their lack of good records, and I hope you find one soon! In fact, I'd consider even going to someone else for the work your current dentist has suggested. I have a great dentist but it took a few tries and then asking for colleagues' recommendations.
posted by smorgasbord at 9:24 PM on January 11, 2016

Try different dentists (difficult to execute, I know). It's the only way to get one you're personally comfortable with. There's a huge variety of standards and if you feel iffy about it, it's a sign to go shopping around a bit. You can read all you want about procedures, standards, etc; which is diligent and important. But actually meeting different dentists, evaluating their approach, is also useful for customers' continued education about these services. There's no secret rule that says you're supposed to stick with the same one. It's very much a professional-client relationship.

My family has many dentist friends, so that's sort of the culture I've observed.
posted by polymodus at 9:26 PM on January 11, 2016

Also, this: becoming a better advocate for our medical care is good but a good doctor will not make you feel like how you're feeling right now. They can deliver the same news in a much kinder way. And please don't feel alone in this: I had a great OBGYN for a few years but have started feeling judged these past two (she first didn't bother to read my records and asked if I was having any more children when I've been a childless/child-free patient their for the past nine years, then chastised me for eventually wanting children but not rushing to have them before 35, etc.) Needless to say, I'll be trying someone new next time: same practice but a different doctor. If you need help searching for one or your wording when you set up the new appointment, let us know!
posted by smorgasbord at 9:29 PM on January 11, 2016

Get a new dentist. Cancel your future appointments and find one that will actually listen to you. If your dentist is sending you away in five minutes with a sample of something find another place to go. They are not just some walk-in clinic, this is a professional who you should have a trusting relationship with. I've gone through three dentists in the past five years, great ones are worth hunting for.

If you stick with them or if you find this problem with a future dentist make a plan or, if you can, see if you can role-play with someone (if that sort of thing helps you). Remember that in the future, if she tries to rush you out, bring up that she'd found decay in places that had really bothered you before and that you would like to get an x-ray of it. So maybe writing it your plan would look like:

1) This is worrying me and I would like it to be checked out.
2) This has been an issue before and I'd like it to deal with it now.
3) I would like to get an X-Ray.
4) I know my teeth, what cavities feel like, and would like to get an X-Ray.
5) If you do the X-Ray you will find cavities.

You will not sound petulant saying any of these things. Do not worry about sounding petulant. This is a health-care professional and you're coming to them with a health-care problem and it is their job to deal with it. If you say these things and she flat-out refuses to do them then you should definitely, absolutely find another dentist.
posted by Neronomius at 9:29 PM on January 11, 2016

Thanks, everyone, for your responses so far -- I had a feeling that "get a new dentist" was going to be the consensus. I am not particularly attached to this dentist -- she used to have an awesome admin person who was good at helping me work with my crappy dental plan, but I think that person is gone indefinitely (had kids).

Other than finding a new dentist (which, if I have to, will probably be the subject of a future AskMe..), I would appreciate general tips for expressing my concerns in a way that maximizes the chances they will be heard: my previous visits were basically along the lines of "Yeah, this spot feels funny. Oh, you don't see anything problematic? Okay, bye!", because I (reasonably, I think) trusted my dentist's judgment. The next time this happens (whether with this dentist or someone else) I would be more skeptical.
posted by btfreek at 9:33 PM on January 11, 2016

You said today was a "regular checkup"; were past appointments focused on major work? Did the issue of the sensitivity and tooth discoloration happen to come up after other work was done, at the end of the appointment? Because there's only so much that can be be accomplished in any single timeslot; and sometimes, procedures wind up taking more time than was anticipated (e.g. because a root turns out to be weird, whatever).

If you've got a lot of stuff that needs doing (e.g. a truly absurd number of fillings), you would probably be better off booking separate appointments to deal with particular problems. (If you had like two root canals done in one appointment, it might have been that your dentist lapsed a bit with communication, if she was very focused on whatever was done that day; that might also explain why she forgot about the sensitivity etc.)

Are you happy with her work in general? If so, at the beginning of the next visit, communicate your concerns, discuss what the focus should be that day, and talk about the overall treatment plan.

(Also, teeth are a bit funny, in terms of pain - there are a lot of nerves in the mouth; pain felt in one place may be referred from somewhere you wouldn't imagine.)
posted by cotton dress sock at 10:55 PM on January 11, 2016

my dental plan only covers annual visits

Ah yeah - you're right, the dentist is probably concerned with the tooth-fixing part, above all, and less mindful of the insurance coverage than her office staff would be - but you can bring that up when you talk about your treatment plan (at the beginning).
posted by cotton dress sock at 11:03 PM on January 11, 2016

The past appointments where I pointed out the sensitivity etc were ones I arranged for that specific purpose: I noticed something wrong during my usual brushing/flossing routine and called in. The annual visits I was referring to (and she recommended I have done more often) are the preventative maintenance ones where you get x-rays, cleaning, fluoride treatments, etc.
posted by btfreek at 11:17 PM on January 11, 2016

"I have a history of being able to identify pretty accurately some spots that later actually gave me trouble. So...this spot here (point/describe) seems funny and hurts, and I would like you to give it an extra careful look."
This, and when you have your first talk with your new dentist, tell the story of your previous one.
posted by Namlit at 2:39 AM on January 12, 2016 [2 favorites]

Also, be prepared to repeat yourself between appointments. When you get your new dentist, give them an overview of your history (ask if there's home care you can do if it crops up again and at what point should you come back early vs keep an eye on it), but still reiterate if you go in for sensitive spots again:"I have a sensitive spot here, and last time I noticed that it eventually became decayed." Some professionals are great and taking notes and remembering those small details without prompting, but even great ones can have an off day. I find it's easier to advocate for myself if I start off strongly and don't give them a chance to fail.
posted by ghost phoneme at 5:49 AM on January 12, 2016

I am of the opinion then when the dentist/hygienist asks "Do you have any problems going on in your mouth we should know about?" and you tell them, they should LISTEN.

I don't hear that your dentist/hygienist is listening to you. I'd get another. Yep, just adding to that chorus.
posted by Ms Vegetable at 7:41 AM on January 12, 2016

I used to be a pretty trusting and passive patient, but since becoming a parent I've found that I have to take a much more active role in my family's care, and that doctors seem to appreciate it. My new mindset on this is, try to remember they're just people, and they WANT to do a good job, and they're not omnipotent. You're the expert on your own body and providing that expertise helps them provide theirs. They also know nothing about your insurance.

So don't just say "this feels funny," tell them exactly. Like "this spot here feels exactly like the spots that became cavities used to feel. Please take a careful look, ok? What steps can we take now to forestall further decay? I need to get it all done today as my insurance won't cover another visit."

These days I find myself asking whether the specific thing that's happening is something the doctor has seen before, and how often, and how things typically shake out, and what she's seen be most effective... and if she's at all hesitant, I ask "are there specialists who might have deeper experience in this specific thing?" and "can you refer me?"
posted by fingersandtoes at 9:48 AM on January 12, 2016

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