Dental Risk Factors: Management Versus Treatment

June 1, 2022 Lee Ann Brady DMD

One of the most important things I aim to do is create clear expectations for my dental patients. Over the years I have intentionally tried to shift my language from discussing “treatment” to “management” when talking with patients who have dental risk factors that will persist throughout life. Perhaps, the following short discussion will empower you to do the same.

By being intentional about this, we can:

  • Reduce patient frustration,
  • Avoid patients thinking we have failed them,
  • Boost their confidence that we are working together to address their oral health problems, and
  • Inspire them to try management therapies and return to therapies that helped in the past when there are flare-ups.

When I describe something as a treatment versus describe something as a management therapy, I inform my patients about the difference and explain why management therapy may or will never eliminate the underlying cause of their oral health issue — but by continuing to manage their issue therapeutically throughout life, they will hopefully reduce discomfort and disease.

I make a clear distinction that treatment fixes a problem, and in their case, the problem may not be fixable, although it can be managed. For example, I focus on this when the patient is truly at high risk for periodontitis. This is a patient who has suffered from bone loss and has a body that is highly reactive to the bacteria in the inflammatory disease known as periodontitis. I also focus on this when the patient has significant TMD issues.

When I tell a patient, that we are going to treat something, the use of the word “treat” sets the expectation that the problem will be eliminated. That is very different from a management strategy that helps to reduce the symptoms and/or the continued degradation of their oral health. When we tell patients we are going to do scaling and root planning and we’re going to “treat” their periodontitis, it can be really challenging for them when we recommend that they do additional periodontal therapies.

When we think about periodontal risk, functional risk, and caries risk, the reality is that risk is a bell curve. There are some people whose risk factors are easy to manage, and some people whose risk factors are very challenging to manage. We need to help patients understand that when they have certain risks, certain disorders, there really is no treatment. What we do have is a lot of therapeutic modalities that can help manage the damage, manage the symptoms. Sometimes these modalities are so effective that it appears the disorder has gone away.

We need to recognize and the patient needs to know that the disorder really has not gone away and can surface again. With clear expectations, our patients (and we) do not have to experience disappointment and frustration. Instead, we can have supportive, empathetic conversations, and move ahead with restarting therapies and trying new ones.

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About Author

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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