© Pavel Ilyukhin | Dreamstime.com
Dreamstime M 60302382

Troubleshooter: What to do about a dentist who underdiagnoses?

Dec. 5, 2019
This dental team is concerned about the dentist losing his passion for the practice, and as a result, they think he's underdiagnosing his patients. What can they do?

Nearly everyone has problems and concerns on the job, and sometimes you're just too close to a situation to solve something yourself. Share your concerns with Team Troubleshooter, and the experts will examine the issues and provide guidance. Send questions to [email protected].

QUESTION: I’m a hygiene assistant who currently holds a CDA. I’ve been to our office for over a year and it seems the dentist has lost interest in diagnosing dental decay. He rushes through dental examinations, and even if the hygienist writes down “problem areas,” the doctor wants to “watch” the tooth instead of properly diagnosing the decay. It drives us all crazy as we can clearly see the decay on the x-rays, etc. He has made comments about how he doesn’t want to be the guy who tells people they have decay under their crowns, or they have recurrent caries. Isn’t that what a dentist’s job is in the first place? We feel the dentist has lost his passion and just doesn’t want to be bothered. We’re a great dental team but we don’t know how to help him get his spark back. Our team has stopped being aggressive with him about treatment that should be diagnosed because it’s a losing battle. But we feel like we’re failing our patients! How should we confront a dentist when he’s lost his passion for dentistry?

ANSWER FROM DIANNE WATTERSON, MBA, RDH, founder of Watterson Speaking/Consulting:

Most likely, this dentist is ultra-conservative, the true opposite of the super-aggressive dentist. I wouldn't want either one of this type to be my personal dentist. The ultra-conservative dentist will often "watch" small areas of decay rather than bring a patient back and intercept early decay. And they do know that some decay can be arrested. I think the ultra-conservative dentists are fearful of being labeled as aggressive with treatment planning, and they often provide the least expensive treatment for patients, such as a huge restoration instead of a crown. They don't like breaking bad news to patients, quite possibly because they don't want patients to think they’re ripping them off.

There needs to be a happy medium with treatment planning, one that isn't too conservative or too aggressive. The best way to support a dentist like this is to encourage him by complimenting his dentistry from time to time. Try not to second guess his treatment planning. After all, it is his practice, and if his treatment planning fails, he will bear the consequences of his decisions. I think it's a good idea to encourage the one who signs the paycheck. The answer is to accept his treatment philosophy, which is ultra-conservative. Personally, I'd rather work with someone who espouses conservative approaches rather than someone who over diagnoses.

More popular Troubleshooters

Dental practice liability and radiographs
Coworker driving hygienist crazy with her constant gabbing
Can dental practice forgo insurance payment if patient agrees to treatment amount?

Don't be shy! If YOU have a tough issue in your dental office that you would like address, send it to mkaiser@endeavorb2b for the experts to answer. Remember, you'll be helping others who share the same issue. Responses will come from various dental consultants, as well as other experts in the areas of human resources, coding, front office management, and much more. These people will assisting dental professionals with their various issues on DentistryIQ because they're very familiar with the tough challenges day-to-day practice can bring. All inquiries will be answered anonymously here on DIQ.

Originally posted in 2019 and updated regularly