Does your surgeon make these mistakes?

It is about management and procedures around the dentist's field of work in a general practice.

In this post you will find inspiration for:

  • Better procedures for dental assistants

  • Procedures that give patients a better experience

In an attempt to keep the reference to a manageable length, I have chosen to describe only parts of a procedure.


Man with blue surgical mask and cap stares out through picture

Classical challenge

Some time ago I had a conversation with a general dentist who had a liking for the surgical treatments. He was happy to have the opportunity to work exclusively with surgical procedures a few days a week.


While we were talking about his enjoyment of surgery, a dental assistant came and asked the dentist to answer the phone. She told us that a patient who had had an operation a few days earlier was in a lot of pain. Clearly annoyed by this interruption, the dentist went to the phone to talk to the patient and possibly find a medical solution to the problem.


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Challenged leadership

While the dentist was talking on the phone, I asked the dental assistant how often the practice had this kind of phone calls. The dental assistant told me, with a defiant attitude, that it was on a weekly basis. This puzzled me and prompted me to ask about the practice's protocol for pain control. The assistant looked at me puzzled and said she didn't know anything about that. It was the dentist who was in charge of that.


When I later asked the dentist about the procedures for pain control after surgery, he replied that it was the duty of the dental assistant to inform the patient that he could take some paracetamol if pain occurred after surgery.


This was a somewhat different procedure from the one I had worked with when I was a practise owner. So I asked if there were other measures that were used to give patients a good experience. The dentist said he had the dental assistants call the patients the day after the surgery to see if everything was OK. In addition, he did not have any procedures related to the patient experience or pain control.


Where were the challenges?

3 things caught my attention.

  1. Lack of clarity, as a result of blind spots in the practice leadership and management.

  2. A dentist who got overwhelmed by even small challenges.

  3. A pain protocol that did not provide patients with a good experience.

To keep the blog post within a manageable size, I'll just stick to the patient experience, which is strongly linked to point #3: Pain protocol.



NSAID

I asked why NSAID agents were not used for pain control.

Referring to the much publicity that had been given to young athletes on long term treatment with high doses of NSAID and the related heart attacks, the dentist did not think it was justifiable to use NSAIDs. He had therefore changed his approach to using only paracetamol and prescribing opioids for severe pain.


Disclaimer

As it is more than 3 years since I stopped practicing, I don't know if there are new guidelines for the use of NSAIDs in dental practice. However, it seems to me rather extreme to do away with such a good and proven short-term medication in conjunction with surgical procedures in the oral cavity.


I would be particularly concerned about the inappropriate side effects of opioids if I were to discontinue NSAIDs. Especially in view of the risk of more opioid-dependent citizens as opioid use increases.


If I am completely wrong with my recommendations, please feel free to comment on them. Either here or on my LinkedIn page, so I can correct the post.


We all want the best for our patients

Drawing of man hanging by his arms under a heart

You may be thinking that what you've just read belongs in the slightly more extreme category. You may also be thinking that it's perfectly normal. Whatever you think, are thinking or are doing right now, I am sure that you, like every other dentist I know, only want the best for your patients.


In what follows, I will try to give my take on how it is possible to improve the post surgical protocol and then let you decide if anything I write could improve the patient experience in your practice.


Passive or active procedures?

In this context, it is important to consider that just because the clinic has a procedure description does not mean that the procedure will be followed by the team.


Nor is it certain that the procedure will be followed in the way the practice owner intended it to be followed, just because the procedure is documented on paper or in electronic form.


Any procedure requires thorough instruction AND subsequent training, as well as persistent focus and follow-up - until it becomes routine.


Prerequisites for recommendations

To give you the right background to read a small part of my former practice's procedure description, you should know that all members of the team worked according to the motto: "Denmark's best experience".


It was not a motto we had written, hung up in a frame and forgotten all about. Rather, it was something against which all our decisions were held. Not just in management but in the whole team. Everyone had the freedom to interpret what they thought would give the stakeholders of the practice "Denmark's best experience" in each situation.


In all our meetings, we talked about how we could be better at giving our patients "Denmark's best experience". Everyone was constantly working to improve the "Best Experience in Denmark", and we evaluated the situations in which each team member seemed to have been in a difficult situation. These situations were used to discuss what was good and what we could do better, allowing us all to learn from the difficult situations and thereby build an even stronger common direction. A stronger practice brand.


Before treatment.

Starting field on green runway