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