It may be time to have tough conversations with dental patients

Dentist Advise Patient

Clinicians may need to give patients more realistic views of the roles preexisting conditions or lifestyle habits play in the success or failure of their dental treatment. The editorial was published on May 1 in the Journal of Oral and Maxillofacial Surgery.

If dental patients reject or fail to follow through with presurgical and postoperative recommendations, such as quitting smoking, clinicians may need to forgo the excessive risk they undertake and refuse to perform their elective surgeries, Dr. Tara Aghaloo, PhD, associate editor of the journal, wrote.

"The time has come to redefine surgical failures or complications as a patient's inability to heal or simply as a risk of a surgical procedure," Aghaloo wrote.

On a U.S., as well as a more local level, patient risk factors and treatment complications and failures are common discussions in dentistry. Many times, poor outcomes and complications are the result of an underlying cause, including obesity, diabetes, or unhealthy habits like smoking. For instance, those with diabetes have a greater risk of developing wound infections, and those with diabetes and obesity have an increased risk of developing postoperative infections.

Despite knowing and being trained to discuss the risks, benefits, and alternatives of surgery and having every patient sign a consent form, clinicians may not be fully informing patients how their underlying medical conditions, age, and even failing to maintain adequate hygiene routines may affect surgical outcomes, according to the editorial.

Whether it's to increase treatment acceptance, a sense that most procedures end up being fine, or another reason, some residents and practicing clinicians rush through informed consents or fail to discuss them all. In these cases, patients don't understand the risks, potential treatment failures, or what they are expected to do after surgery, Aghaloo wrote.

To change the treatment failure narrative, clinicians may need to help patients understand their medical conditions and how they may affect post-procedure healing. Patients should be informed that their age can affect healing, and sites that have undergone procedures in the past may have poor tissue quality and scarring that can affect outcomes, the author wrote.

Additionally, patients should be committed to take steps like managing their blood glucose levels, starting smoking cessation programs, improving their dental hygiene, and maximizing bone health.

"The time has come to make it clear that a poor outcome is not always a surgeon's complication," Aghaloo wrote.

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