A Story about Nelson Neglectful

Here's a story about an all too common situation we encounter as dentists.  Hopefully, it provides some insight into what we face as practitioners:   

A rarely seen patient or new patient named "Nelson Neglectful" appears in my chair one day in pain or with a broken tooth, and he wants me to fix it.  I tell him, "Of course I will, that's what I'm here for," and I do right by him.  But when I'm all finished, I take a quick look at the rest of Nelson's mouth and see problems, problems, and more problems.  Whether its more restorations, root canals, or crowns -- Nelson needs work.  Badly.  So I sit him up in the chair.  Maybe I hand Nelson a mirror or take some pictures to help him visualize my point, but essentially I look him straight in the eye and explain to him that he will have consistent, recurrent dental problems and pain in the future if he doesn't start seeing me on a regular basis.  Otherwise he'll experience massive tooth loss.  He is at the decision point, a major fork in the road.  Its not too late, but it will be soon.  Nelson nods, seeming to understand, and then leaves my chair to make another appointment...and promptly cancels, disappearing into the ether... 

...but sometimes he doesn't.  There's Nelson on my schedule!  There's Nelson in my chair!  He listened, he cares about his oral health...Yippee!  Lets get to work.  Diet control -- cut out the sugar!  Hygiene control -- floss is your new best friend!  Dental Phobia control if its necessary -- we're here to help!  MASSIVE cavity control.  We are fixing it.  Nelson is taking control of his problem.  Then, mysteriously, he disappears... AGAIN.  Why?  Nelson's previously neglected insurance benefits suddenly ran out.  It doesn't matter that my front desk took the time to explain these benefits to him, it still comes as a shock.  Apparently, his oral health is only important enough that he will address it if its not an out of pocket expense.

This story isn't referring to the patient who has true financial difficulties.  We are in tough times, and sometimes sacrifices have to be made.  Its also not referring to the high anxiety patient who has dental phobia.  Nelson Neglectful is the patient who just puts his/her dental health at the bottom of life's list.  An expensive cell-phone plan, some cool shoes, just about anything is more important than putting some money aside for much needed dental treatment.  It breaks my heart that I can't get through to this kind of patient.  I've seen what becomes of them down the line.  Nelson Neglectful, now "Tony Toothless," looks up from my chair with somber eyes and inevitably laments, "Man, I wish I had taken better care of my teeth."

I wish I could get through to Nelson before he becomes Tony.  Any ideas?

-DRS

Snoring Problems? A Dental Appliance May be the Solution

The night before my application interview at my future dental residency in Richmond, VA, I was pretty nervous.  And when I get nervous, I have trouble sleeping.  Lack of sleep the night before some important event is nothing new for me, but usually I eventually fall asleep and the effects are annoying but tolerable.  On this night, though, I got no sleep whatsoever.  Why?  Sharing the small hotel room with me was a friend/colleague of mine who was also interviewing for a residency position.  And this friend (lucky for me) snored at an incredibly high decibel.  Think of the loudest, oldest, rustiest chainsaw being revved up over, and over, and over again all...freaking...night.  Needless to say he was the worst snorer I'd ever heard, and I was miserable.  Around 3:00 AM I was so bored and distraught I actually recorded his snoring on my cellular phone to play back for him that next day.  Obviously, the interview wasn't fun for me, but he and I were both accepted to the residency.  When I played his snoring back to him, though, he was pretty surprised at how bad it was.

Skip forward to four months later.  This same friend of mine and I (now busy dental residents) had to once again share a hotel room for a dental conference.  Obviously, I was dreading the experience.  However, this time when we hit the sack there was nary a peep from his corner of the room.  I was pleasantly shocked and slept like a baby.  When morning came I saw the reason for this transformation: my friend was wearing some sort of mouth-guard.  When I asked him about the device he smiled and told me that listening to my recording had spurned him to action.  He decided to enroll in a sleep study and learned that his snoring resulted from a  form of mild sleep apnea.  This same sleep apnea was preventing him from achieving sound, quality sleep.  Not to mention disrupting the sleep of anyone in a 5 mile radius!  Anyways, to fix the problem, he had one of our dental instructors fabricate an oral appliance (the mouthguard I saw him wearing) which positioned his lower jaw in such a way that his airway stayed open throughout the night.  Poof!  The sleep apnea all but disappeared.  He told me he was amazed at how refreshed he has started feeling after using the device, and that he couldn't believe how much of an improvement it has made.

Snoring and/or sleep apnea can be a major problem for some people.  Amazingly, the solution in the form of a dental oral appliance is not well known.  It definitely worked for my friend, and I know he continues to use this device to this day.  His newly acquired fiance can attest to that!  A few of the better known brands of these appliances are the TAP , the SomnoDent and the Silent Nite, but there are others.  So if you have a snoring problem and you would like to seek a solution, try telling your local Northford Family Dentist about it.  The solution may lie with one of these devices

-DRS