Charlie Nicholas offers an elegant solution to troublesome treatment planning for endodontic cases.
Working as a GDP can be a lonely existence and with a busy list of patients it is often hard to take the time to plan and prioritise a patient’s treatment. In addition to this is the uncertainty as to whether particular types of treatment are even viable, and if so what could their degrees of success be? Is it something a GDP could tackle or would it need an expert to tackle it? These are all questions asked several times in a day and often require multiple disciplines and discussions with colleagues or experts.
Tricky treatment planning
Endodontic treatment can be one of the most difficult areas in dentistry to plan, for all of the above reasons and more. From location of root canals to restorability issues to retreatment or fractured instrument removal, endodontics can be very straightforward or near impossibly complicated. The difference between success and failure, from complicated to simple, can be very subtle. Get it wrong or make your patients promises you can’t keep and the situation can become very stressful very quickly.
We have all been in the situation where patients simply aren’t happy with the opinions you have to offer relating to their treatment. They either don’t want to accept the inevitability if a tooth really has come to the end of its life, or they struggle with the fact that it may be a procedure you just don’t feel confident to carry out and need expert advice.
We then have no option other than to explain to the patient that if they do want another opinion this will mean a referral to the appropriate specialist or expert. This may involve a lengthy wait, a large distance to travel and sometimes a costly consultation fee. The patient may have to take a period of time off work to attend the visit and often the outcome will be that the treatment isn’t viable, and the patient is returned to the referring dentist for the necessary remedial care.
The fortunate side of this situation is that many of the potential pitfalls, prognoses or problems associated with planning endodontics can be assessed purely from an accurate radiograph. Obviously, there are many other issues that can arise, but from a very basic ‘triage’ perspective a radiograph can provide guidance in most situations.
Professional endodontic triage
Understanding all of these issues has been fundamental to us at The Dentistry Cloud. It encouraged us to incorporate a triage service into our secure online portal, which also enables dentists to send, receive and manage patient referrals. Any dentist who wishes to seek an expert opinion on a patient’s endodontic treatment can simply send us the patient’s details and upload the appropriate radiograph through The Dentistry Cloud portal.
Within 24 hours we will return a detailed report on our findings, with recommendations on how we feel it would be best to proceed. We will also provide a PDF version of this report for the patient in suitable language that they will understand. Although clearly we will never be able to provide a complete consultation service without physically seeing the patient, we can provide some very important information, enabling the dentist and patient to make a much more informed decision on the next steps they wish to take.
If we think the tooth is a poor candidate for endodontic intervention, we can advise of this with degrees of prognosis if it were something the patient was still keen to investigate. If we feel the treatment is relatively straightforward we can help guide the referring dentist down this avenue, providing them with a greater degree of certainty and confidence to carry on with the procedure. It may well be a more complex situation; in which case we may advise that the patient would be best to see an expert, and through the referral portal advise of the nearest practitioner who is registered with The Dentistry Cloud.
A confidential second opinion
One of the main reasons I enjoy running training courses is the contact you have with so many enthusiastic dentists. A frequent consequence of spending so much time meeting colleagues is the resultant requests for opinions on work they’ve carried out or problems they may be having with a patient’s treatment.
This can be a very stressful and very sensitive time for dentists and often it is difficult to find anybody suitable to discuss this with.
At the Dentistry Cloud we have provided a facility for any dentist who is worried about a patient, to upload a radiograph with details of their concerns. We can then reply quickly with a non-judgemental, confidential response to put them at ease and allow them to take the appropriate course of action. All they need to do is sign up to the service on the website as an individual dentist.
The portal can be accessed and used anywhere with a suitable mobile device including laptops and tablets. Radiographs can even be photographed with a tablet and then uploaded through the portal. Just visit the website for more information.
For more information on The Dentistry Cloud’s services, visit www.dentistrycloud.com.