My Dad, who is really an incredible guy, was 72 years old last year and still going strong. His mouth, however, was not. Last November, I got up the nerve to confront him on his neglect of his mouth. Christmas was coming and I thought how nice he would look in family photos if he smiled instead of squeezing his lips together. Sometimes, you just have to say something if you really care about someone.
I started off by politely asking him how old his upper denture was. My suspicions were confirmed when he proudly informed me that it had lasted 30 years. I took off my velvet gloves and told him it looked that old — yellowed, a tooth missing in the front, fissures, etc.
Now that I had gotten onto the subject and was on a roll, I asked him how many teeth he had on the lower end of things (no denture there). I was pretty sure I already knew the answer and he confirmed my observations — two of his natural teeth left standing all alone. I suggested that perhaps that was why he didn’t smile much anymore. He pinched his mouth into a frown and said that he didn’t think he ever had smiled much. He was getting defensive — maybe I was making some inroads here. I moved in for the kill by asking what kind of food he ate and he said most things as long as they are soft. I asked him did he know what he was doing to his digestion and didn’t he miss steak and things? He shrugged.
I told him we were consulting a wonderful denturist quite near his house whom I was sure he would like. I suggested it be wonderful to do something about this in time for family Christmas photos. I told him that for someone who has a 4 bedroom house, drives a Crown Victoria car and does all his investing via the Internet, he really is neglecting himself. I told him he should have the best in his mouth as he is worth it. At this point, I hugged him and told him I loved him and left him with his thoughts.
Three weeks later, I received this emergency call from my Dad at 5:30 p.m. on a Friday asking for the name of the denturist I had mentioned. He had just broken off one of the two remaining bottom teeth. Nothing like a crisis to make you take action!
Thanks to me and his denturist, he now has a top end set of dentures in his mouth and a natural smile again. He looks happier, smiles more, and the best thing of all — he was eating BBQ steak at my house a couple of weeks ago! Sometimes a kid has to reverse rolls on their parents and give them the love and care they have earned.
The New Way:
See You Once A Year
None of this dialogue between my father and I would have been necessary, however, had my Dad been on a recall program with his denturist. His denture would have been checked over once a year and he would have been on about his fourth denture by this time (a new one approximately every seven years). Additionally, his denturist would have seen when it was time for a lower denture and I would not have had to get up my nerve to say something.
An effective recall program is comprised of a number of procedures and each one is necessary in order for the program to work. The following is an overview of how an effective recall program should work:
- At the end of the patient’s current treatment, get them to commit to their next appointment for a recall — this will usually be in 12 months. Get the patient to complete a recall card (which will be mailed to him) with his name, address, appointment time and date. (See “Patient Education” section further on in article.)
- File the card in a tickler file system in the appropriate month.
- Mail the recall cards out about 3 or 4 weeks in advance of the patient’s appointment.
- Phone the patient 24 to 48 hours in advance of their appointment and remind them. This is just a courtesy call, not an invitation to change their appointment.
Most patients have been indoctrinated into seeing their dentist every six months for most of their lives up to the point of getting dentures. However, once a patient’s natural teeth are gone, they are generally of the opinion that they no longer need any sort of regular oral check up. This is most likely because they were not aware of all the reasons their dentist did a recall exam in their mouth. Dental patients are not usually aware that the dentist is checking the oral pathology of the gums and mouth. This omitted piece of education is probably the major barrier to getting patients to come back to their denturist for a regular recall.
Prepare A Brochure
A simple brochure could be prepared to give to your patients which would outline the reasons for a recall. Here is a sample of what you could say in the brochure:
A recall check-up is important!
The following are a few of the important things we check for at your recall visit:
Changes in tissue: Your mouth is continuously changing. The shape and size of your gums are not the same as they were the day your dentures were made. For this reason, it is important to have the fit of your dentures checked regularly and adjusted.
Check for oral cancer: Oral cancer can arise at any time and can be found in many patients wearing dentures. A regular check up by your denturist may be the only way to detect oral cancer in the early stages.
Update medical history: Medications can greatly affect the tissues of the mouth as well as affect saliva and the ability of the body to combat bacteria in the oral cavity.
Check for Denture Wear: Dentures can wear over time, causing difficulty in chewing and speech. We can tell you if your dentures are wearing at an acceptable rate and make any corrections that may be needed.
Check for TMJ Syndrome: TMJ is a condition involving pain in the jaw joint that might be caused by ill-fitting dentures and an incorrect bite. Symptoms: ringing in the ears, dizziness, popping or cracking sound in the jaw joint, neck pain — to name only a few.
There are lots of other ways you could say the above but those are the key issues to include in the brochure that you give your patients or mail to them.
Fee For Recall
Inform the patient in advance that there is a small fee for their recall visit (see your provincial fee guide). If they have insurance, let them know that they may be covered and that you will help them complete the necessary paperwork for their claim.
Keep ‘Em Coming Back
Keep your patients well-serviced and coming back. Give them the quality of care they deserve to have.
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