Is the patient right?

In a Dr. Bicuspid article on April 27, 2016 titled “Never believe your patients,” Lisa Knowles, DDS made a case for not necessarily believing the patient who indicates a particular tooth that is causing a problem. In the case cited, the patient provided misleading symptoms causing a dental student to propose therapy for the wrong tooth. The student didn’t see anything wrong with the tooth, but since the patient indicated it was the cause of the problem, the student proposed the treatment.

The patient’s recitation of misleading symptoms was unintentional. But if the student had proceeded as indicated, treatment would have been performed on a “good” tooth, not the “bad” one that needed treatment. Dr. Knowles’ point was that you should prove to yourself that your diagnosis is right. Sometimes this takes more investigation, be it asking more questions, taking additional x-rays or considering additional diagnoses. In the case highlighted in the article, a visual examination revealed a problem on the tooth next to the one the patient indicated that the x-ray didn’t capture.

When time is short, it can be easy to merely accept a patient’s story, but it is worth taking the time to make certain the story matches your diagnosis. If it doesn’t match, do more investigation to get the right diagnosis.

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