(BiteFX Forum Article posted by Suzan Bekolay of Click Coaching)
- Appliances in drawers
How many patients complied with the recommendation for an orthotic (a term I prefer over splint), wore it for a while and then eventually found it's way to the drawer instead of nightly use as “recommended”? So much for prevention! Those who experience symptoms may demonstrate more adherance. In the interest of clarity; compliance is cognitively, externally derived and adherance is internally derived - the problem and solution is owned and valued. To a number of patients, especially to those who are essentially asymptomatic - who more likely complied - the orthotic can be misunderstood as nothing more than a wedge of plastic they can grind on rather than their teeth - like the one their neighbour got for half the price. Some will have quiet buyers remorse, some wonder why “the splint” cost so much more or any number of misperceptions; all being silent subtractors to value the worst element being silence. Such misperceptions expose Doctor to risk of skills and purpose being undervalued or worse leave patient's sensitized to having been “sold” even thought softly. Hmmm….enthusiastic referral? Those with the appliance in a drawer are some times also at full stop in movement towards health when the appliance was intended to serve diagnostically; as a first step.
Whether diagnostic, therapeutic, or protective, doors can be opened by the hygienist or facilitator to both enhance perceived value (for the investment and doctor) and in some cases move beyond diagnostics to occlusal rehabilitation.
We identify all patients of record who have an orthotic. We put together a simple sequence of 3 BiteFX animations calling it “orthotic not splint” which includes healthy bite/destructive bite/ the appliance being inserted. For those who are episodically sypmtomatic, a sequence including muscles fits. (KISS) Pre, during or post a hygiene visit whether the client is using the appliance or not; we acknowledge that the client has invested in an appliance and with their permission would like to show them what the appliance is actually doing “in case we missed the boat”. It triggers some valuable conversations and “aha's”. Sometimes stimulating adherance, sometimes leading to a renewal visit whereupon we can revisit the problem of destructive bites and sometimes, re-engaging patients in the diagnostic use to then move on to the next phase of treatment.
(Yes, sometimes we have to plan the work then work the plan and allow add 10 minutes to their hygiene visit)
How do you ensure your patients continue to use their dental appliances? - Let us know by using the comments link below.