Late Blooming Rose

September 2006

By: Dr. Scott R. Harden

When you think of a Rose the connotation of serenity and beauty comes to mind. There are many kinds of roses, English roses, climbing roses, tea roses and floribundas to name a few. They come from all aspects of the country, from Florida to California. The Rose I recently encountered happened to be from New Jersey, and possessed no elements of serenity and peacefulness whatsoever. This Rose, of the two-legged variety, actually walked into my dental office and presented because of her recently developed dental emergency. Rose was ironically very similar to her floral counterpart, for although she was beautiful, the dental phobia she possessed instilled a quality in her personality that was certainly representative of thorns.

Rose’s husband accompanied her into the treatment room providing her moral support. “No offense, but I really hate coming to the dentist . . . nothing personal”, stated Rose as she reluctantly reclined in the dental chair with stiffened back muscles. “I’m only here today because I broke my front tooth and I want you to fix it”, she requested with a sense of urgency.

The response Rose was demonstrating is a very common reaction displayed by patients during a visit to the dentist. Baby boomers especially have enough memory of dental procedures from an era when dentistry was truly challenging for patients. This was a time when children often had twenty to thirty cavities, dental procedures were old-fashioned by today’s standards, and it is not hard to understand why these patients still manifest anxiety during a visit to the dentist. Today, dentists and their staff have the challenging role to appreciate the basis of their patient’s fear so they can provide superb levels of customer service to offset this anxiety and help the patient through the phase of treatment they so desperately need.

Rose’s examination revealed her top front tooth had fractured off at the gum line. She had never had trauma to this tooth. Why did this happen? Years ago, Rose had all of her upper and lower back teeth extracted. Her front teeth were all she had left and she was using them beyond what her teeth were capable of tolerating. Therefore, eventually one of her teeth finally broke off and sadly was going to require extraction.
The loss of a front tooth makes all the difference to a patient, even if they are severely apprehensive about going to the dentist. Vanity is a strong motivator and often precipitates the patients desire to seek treatment. In Rose’s situation, she was further motivated by her daughter’s wedding that was only a month away.

Rose simply wanted her front tooth restored. However, her broken front tooth was a signal from her mouth, yelling for help. Rose’s emergency exam revealed significant findings. Several other upper teeth had fractured, again from by over-utilized, and were going to require extraction. Her remaining lower teeth were decayed, had chronic gum disease infection from avoiding professional care and were all very loose due to advanced bone loss.

How do you present this information to your patient that is looking across from you with a look of panic on their face? They sense there are a lot of problems in their mouth. They want to deny it even while sitting in the dental chair, because they are so scared about receiving any treatment at all. They especially don’t want to consider more advanced treatment.

Rose sat waiting with for an answer to her problem. Compassion and directness are the two best components for a positive response from the patient. Rose needed all her lower teeth extracted and replaced by a complete lower denture. She further needed several upper teeth extracted with options for a partial denture or bridge. “How can I look good in a month for my daughter’s wedding”, she inquired? Her treatment plan was discussed and resolved. Rose returned the very next day to begin treatment and prepare for her daughter’s wedding. The result of a beautiful new upper bridge gave her an instantaneous transformation to a beautiful smile in less than two weeks. She was thrilled with her new smile and ready for her daughter’s wedding. The remaining treatment, removing her lower teeth and placing an immediate lower denture, would occur upon her return from the wedding. Rose was now devoid of her thorns.

Patients will often avoid going to the dentist, ignoring pain and infection, until they are desperate. This is now a much more difficult situation for everyone concerned. My advice is to receive regular dental exams, twice a year, and take care of your oral health, if not for yourself, perhaps for your children. After all, we never stop being a role model to them.