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Timeframe and communication in the dental school clinic

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    My last blog post I spoke about what to expect in the dental school clinic and the different types of professors. In this blog post I want to talk about treatment timeframes and communication mistakes to avoid with patients and what to do in order to succeed in the clinic.  

Most mistakes I have made were not related to the actual procedure in dentistry, but instead were related to the treatment plan execution and the way I communicated with my patients. The first mistake everyone will make multiple times is giving the patient an unrealistic timeframe. Everything in dental school goes EXTREMELY slow, sometimes patients come from private dentists and do not realize that at the school treatment will take significantly more time to complete. For example a root canal with a dentist will normally take from 1-3 hours depending on the tooth. For students it can take as many as 4 appointments that are 3 hours each, so literally they will spend 12 hours getting one root canal and that doesn’t even include the post, core and crown. No wonder patients don’t like root canals. But if patients are willing to spend the time it will also be significantly cheaper. The timeframe for completing all treatment is therefore extremely long. Here is an example of one patient that it has been over a year and treatment is still not completed.  

The patient started out by getting x-rays, two weeks or so later I called her to set up an appointment for treatment planning. We tried to schedule an appointment every week. First appointment was December 2014, the treatment plan took 2 appointments and then we had winter break. We came back in January 2015 and did a periodontal diagnosis (1 appointment) and scaling and root planing (3 appointments). February, multiple cavities, 1 extraction and spring break (7 appointments). April root canal on a tooth that did not need a root canal but the professor insisted. May  prep and temp for 4 crowns (5 appointments). June impression for crowns, lab work and sent out to lab (4 weeks). July one crown missing contact send back to lab to fix and summer break. September prep teeth for partial take impression for partial, send models to lab for framework (5 weeks). Mid October framework try-in, adjustments and competency. November jaw relations, altered cast and wax try-in (3 weeks). December wax try-in and send to lab, lab unable to send back case before winter break. Plan: insert partial January 2016, prophy and done.  

This is the longest I have ever worked with the patient and I made the mistake of giving her an unrealistic timeframe because she kept telling me she wanted to be done by a certain date, first it was her birthday in August 2015 and at the beginning of treatment I thought, of course I will be done by then, that is like 8 months from now, when I was not finished she was upset. Then she told me she wanted it done by Thanksgiving and I thought, yes I can do that, then it was by Christmas and I was pretty certain we would be done, but here we are and she will not get it until January.  

So I cannot stress enough, it will take EXTREMELY long to complete treatments. You must factor this in when trying to determine if you will complete your requirements on time as well. And tell that to the patient the first day, if they are okay with it great, but if not the school may not be the place for them.  

Communicating with the patient in a way they can understand is important as it will determine how satisfied the patient is at the end of treatment. Patient expectations need to be evaluated and corrected if not in line with what the student is able to do. In this example I should have communicated better with the patient and told her that I cannot give her a realistic timeframe because I simply do not know how long it will take because I have never worked in the school clinic and there are too many variables to consider. Communication and a better understanding of the time needed to complete the treatment plan would have made the patient more satisfied during the course of treatment.