Before Dr. Raz (Irarrazabal) started filing my tooth, I asked her if there was anything else I could do in lieu of getting a crown. I value more the ability to keep as much as possible of my natural teeth and my time and days spent pain-free than I do having a tooth cover even if it is guaranteed not to chip. She stared at me, shook her head and said nothing. A week later, when I went in to have my permanent crown placed, I asked her "Could I have had it filled?". She replied, "Yes, of course..." I still don't know exactly why I didn't explicitly ask if I could have it filled at my appointment the week prior. My regret over that is enormous. I had assumed, erroneously, that if a filling were an option that she would've presented that possibility to me when I asked for alternatives. Seeing the disappointment in my eyes, she said, "You never have to do anything you don't want to do...but there is no way to know whether the filling would've held up or for how long". Words offered a week too late. I recognize that filling it wouldn't have been as secure a treatment option as a crown is but the probability that I'd incur serious traumatic injury from opting to fill the chip wasn't secure either. I felt disheartened by the realization that my tooth was good enough to remain, that a filling would've sufficed. That I didn't need to waste two afternoons of my life in that chair. That I could've spared myself the numbing injections. That didn't need to have a tooth, containing the hardest substance on my body, abraded. That I could've avoided the extreme soreness in my jaw the ensuing 48 hours.
Dr. Raz conveyed clear awareness of my hesitation and aversion to the procedure, admitting, in front of her assistant, that I asked her for alternatives before we started, that she perceived my discontent over the impending procedure the week prior. Yet she did not present a filling as a viable alternative, she withheld information from me. Her action, or lack thereof, has eroded my belief in people's goodwill and authenticity. While she corroded my trust and naivete, one good thing that came out of this is that it gave me a greater appreciation for the providers who, unlike Dr. Raz, practice 'less is more'. It has also increased my respect for providers who, unlike Dr. Raz, stop to exercise transparency in order to help offset the information asymmetry that exists in provider-patient relationships.
This should serve as a reminder to patients that they're the only ones who hold their best interest above all, while dentists are economically incentivized due to the fee-for-service model. Please don't make the mistake I made by trusting Dr. Raz's nudge unreservedly. For example, if/when you're told you need a crown, explicitly ask "Can I have it filled?". If unsure or opposed about a suggested treatment, seek a second opinion from an unrelated practice before agreeing to a procedure, even if the procedure seems minimally invasive.
To the practice, specifically, Dr. Raz-first two reminders- a) getting a crown is much more than merely a 'jarring' experience. The numbing agent alone doesn't mean the process of getting a crown is painless nor simply a brief and mildly uncomfortable procedure. The physical discomfort lingers beyond the patient chair, beyond the declining potency of the numbing agent. For example, even now, months after getting the crown, cold sensitivity persists. b) simply because Medicaid, or any other insurance company, covers all expenses of a procedure doesn't mean that the patient will opt into the costliest or more aggressive procedure. Suggestion: if a patient is averse to a suggested procedure and asks for alternatives, then present the patient with all available options, even those you might deem suboptimal in comparison. Being transparent empowers patients and shows that you respect them enough to invite them into the decision-making process. You can help reduce uncertainty by taking a few extra minutes to list the options and the possible benefit and or repercussion of each. read more
