The Top Thing Dentists Miss or Don't Ask with Patients

Episode #317 with Dr. Tom Viola, R.Ph., C.C.P.

To make the best treatment planning decisions for patients, you need to know their medical history. And to do that, you need to ask the right questions. Today, Kirk Behrendt brings in Dr. Tom Viola to teach you the three key questions to ask patients to get their medical history. What you don't know about your patients could impact their care! To learn what you weren’t taught in dental school, listen to Episode 317 of The Best Practices Show!

Main Takeaways:

Know your patients’ medical history to make well-informed treatment planning decisions.

All you need is the patient’s medication list and an understanding of pharmacology.

Build a good team around you and teach them how to take a good medical history.

Ask patients good, open-ended questions to get the information you need.  

The first question to ask patients is, “What do you take?”

The second question to ask patients is, “Why do you take it?”

The third question to ask patients is, “Did you take your medication today?”

Asking those three questions will help you understand what you're getting into with patients.  

Substance abuse/use has an effect on dental therapy. Ask patients about it!

Quotes:

“We really sometimes miss [important] things when we take medical histories, when we inquire about patients’ medications. There are some things we miss because even we don't think it pertains to dentistry when, in fact, it does.” (08:00—08:12)

“It goes well beyond medications and xerostomia and even system-induced xerostomia. It has to do with, do you know enough about the patient’s medical history to make well-informed, good clinical decisions in your treatment planning? And the only way you're going to really know that is if you know the patient well enough. And the only way that's going to happen is if you know their history. So, medical histories [are just as] important [as] almost anything else you do in your practice, because without knowing your patient intimately and sufficiently, you're not going to be able to make those decisions.” (08:23—08:57)

“The greatest blessing ever bestowed upon dentistry was the fact that you could take the patient’s medical history directly from the patient themselves. They're right there. Right? What more convenience can there be? And the greatest curse ever inflicted upon dentistry was that you could take the patient’s medical history directly from the patient themselves. As in, if they don't know, you're not going to know. And if they don't want you to know, you're not going to know. But you can overcome that obstacle when you realize that all you really need is a list of their medications and a good working foundational knowledge in pharmacology.” (09:37—10:12)

“I will tell you the thing I hear the most. In the beginning of the medical history, this is the question that gets asked, ‘Any changes to your medications?’ And immediately, the answer is, ‘No.’ Why? Because it’s easier to say no than it is to give me, the dental clinician, the information I need to be able to fill in the medical history. So, conditionally, I say, ‘No.’ And everybody’s like, ‘Okay. No.’ And we move on. But we missed so much of what we could've grabbed from that interaction.” (11:01—11:32)

“Build a good team around you. You've got to invest the time and the money, if necessary, in your team to be able to teach them how to take a good medical history, what questions to ask, and how to ask leading questions and open-ended questions to get the patient to give up the information that maybe they don't want to give up, or maybe they don't know to give up.” (11:41—12:01)

“Ask the right questions. So, you've had your teammate ask the questions....