How to Seek Quality Dental Care: A Patient's Guide to Effective Communication

How patients can seek quality medical assistance?

Hello Dr.
Wu,
On the evening of December 30th, I visited the Dongning Dental Clinic on Central Road in Hsinchu, and I left feeling helpless and angry.
I have a cracked filling on my upper left molar that has caused some sensitivity, so I wanted the doctor to diagnose it.
The doctor said there was nothing wrong and that a slight adjustment would prevent food from getting stuck.
Just as he was about to make the adjustment, he suddenly said he needed to take an X-ray without explaining why.
The assistant was confused and almost took an X-ray of my right side, which I had to stop.
After the X-ray, the doctor said he couldn't see anything and was unsure if there was a cavity, suggesting that the sensitivity might be due to my wisdom teeth.

I asked the doctor if he could perform a dental examination to check for cavities, but initially, he was reluctant and wanted me to make an appointment for the following week.
He mentioned that if he cleaned my teeth first, it would dirty the upper left molar that needed repair, and he couldn't focus on two tasks at once.
However, he eventually did clean my teeth and even offered to whiten them—applying fluoride powder? I expressed my concern and asked what this was and why whitening was necessary.
In the past, other dentists told me that my teeth had deep grooves and, due to my dietary habits, they would still turn yellow after cleaning.
But the dentist at Dongning claimed it was due to my mouth shape, saying that I couldn't close my mouth while sleeping, which caused dust accumulation! I found this hard to believe! The doctor responded, "If you don't believe me, there's nothing I can do!"
After the cleaning, my upper right molar started to feel sensitive.
I asked the doctor if it was a cavity, and he said he couldn't tell! He dismissively told me to make an appointment for the following week.
I insisted that he at least check for any issues to justify the need for an appointment! He shockingly said he was unable to address my concerns and suggested I come back when I had symptoms.
I was really upset and recalled past experiences, asking the doctor, "Does the National Health Insurance Administration have a rule that prevents treating all issues at once?" Silence filled the room.
So, regarding the above case, which parts are scientifically supported correct diagnoses, and which are nonsensical? Where can I file a complaint, or how can I understand the policies that create these challenges for doctors? Please provide your insights, Dr.
Wu.
Thank you very much!

Guo Xiaojie, 20~29 year old female. Ask Date: 2003/12/30

Dr. Wu Jinjun reply Dentistry

Dear Ms.
Kuo,
After reviewing the situation you described, it seems that the main issue stems from insufficient communication between both parties.
The physician initially assessed it as a minor crack that could be easily managed, but when preparing for the procedure, they may have been concerned about potential nerve damage beneath the crack or the previously filled area, which is why they decided to take an X-ray.
Their intention was likely well-meaning, but they failed to explain the reasoning to you, which is an area for improvement on the physician's part.
Regarding your mention of the physician stating that "scaling would dirty the tooth that needs repair," it is possible they were concerned that the vibrations from the scaling process could damage the existing filling material.
I apologize for not being certain about this.
As for your comment about "not being able to close your mouth while sleeping, leading to dust accumulation," one theory suggests that sleeping with your mouth open can cause saliva to dry out, making it easier for dental plaque to accumulate on the tooth surface, resulting in yellowish-brown tartar.
However, this can typically be removed with regular brushing and is not overly difficult.
I understand that encountering such a situation can be quite frustrating.
Honestly, I can only advise you not to be too upset, as harboring anger can be detrimental to yourself.
Evidence-based treatment relies on various diagnostic methods outlined in textbooks, including visual examination, palpation, percussion, X-rays, and assessments with various instruments.
If you wish to file a complaint, local dental associations may be a viable option.
I hope this explanation is helpful to you! Wishing you a Happy New Year and all the best!
Sincerely,
Dr.
Wu Jin-jun
Director of Dentistry, Hsinchu Hospital, Department of Health, Executive Yuan

Reply Date: 2003/12/30

More Info

Dear Patient,
I understand your frustration and concerns regarding your recent experience at the dental clinic. Seeking quality dental care is essential, and effective communication with your dentist plays a crucial role in ensuring that you receive the best possible treatment. Let's break down your experience and discuss how to navigate similar situations in the future.

Firstly, it's important to recognize that dental professionals often have different approaches to diagnosis and treatment. In your case, the dentist's initial assessment indicated that the issue with your tooth was minor, which may have led to a misunderstanding when you expressed your concerns. When you feel that your symptoms are not being taken seriously, it is vital to communicate this clearly. You might say something like, "I understand that you believe the issue is minor, but I am experiencing discomfort, and I would like to explore this further."
Regarding the X-ray, dentists typically use this diagnostic tool to gain a clearer understanding of what is happening beneath the surface of the teeth and gums. If a dentist orders an X-ray, they should explain the reason behind it. If you feel that the explanation is insufficient, do not hesitate to ask for clarification. You might ask, "Can you explain why you believe an X-ray is necessary in this situation?"
The issue of your upper left molar and the subsequent discomfort you experienced after the cleaning is also significant. If a dentist suggests a treatment that you are uncomfortable with, such as whitening or cleaning that you believe may exacerbate your symptoms, it is your right to question this decision. You could say, "I am concerned that this treatment may worsen my discomfort. Can we address the pain first before proceeding with any cosmetic procedures?"
In terms of the dentist's comments about your mouth shape and sleeping habits, it's essential to remember that dentists base their assessments on clinical observations and experience. However, if you feel that a statement is unfounded or not applicable to your situation, you can express your skepticism. For example, "I find it hard to believe that my mouth shape is causing this issue. Can we focus on the pain and investigate possible causes?"
If you continue to feel dissatisfied with the care you receive, it is crucial to know your rights as a patient. You can seek a second opinion from another dentist, especially if you feel that your concerns are not being adequately addressed. Additionally, many dental associations have complaint mechanisms in place. You can contact your local dental association or board to inquire about filing a complaint or seeking further assistance.

Lastly, understanding the policies that may affect dental care can help you navigate the system more effectively. For instance, some healthcare systems may have guidelines that limit the scope of treatment during a single visit, which can lead to the frustration you experienced. It may be helpful to ask your dentist about these policies upfront, so you have a clearer understanding of what to expect.

In conclusion, effective communication is key to receiving quality dental care. Be assertive about your concerns, ask questions, and seek clarification whenever necessary. If you feel that your needs are not being met, do not hesitate to seek a second opinion or file a complaint with the appropriate authorities. Your oral health is important, and you deserve to have your concerns addressed thoroughly and respectfully.

Best wishes for your dental health,
Doctor Q&A Teams

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