Dr. Josh Muir and Dr. Tanner Townsend discuss their approach to treating patients when dental treatments go awry 🚨. They emphasize a patient-centric philosophy 🧑‍⚕️💬, focusing on fixing issues and reassuring patients 🤝. Dr. Townsend highlights the importance of addressing potential causes of treatment failure, such as premature chewing 🍽️ on implants, which can lead to complications like infection 🦠 and implant failure ❌. Dr. Muir shares an example of a denture that broke 🦷, reassuring the patient with a free replacement 🆓. Both stress the importance of patient compliance ✔️, clear communication 🗣️, and continuous education 📘 to ensure successful treatment outcomes 🌟.

Dr. Josh Muir 0:00
Hi everyone. We’re here today with Smile Reconstruction, our dental implant podcast. My name is Josh Muir, and I’m here with Dr. Tanner Townsend as well. And we wanted to talk to you about what happens when treatment goes awry, or what happens when we have to change treatment midway because someone doesn’t heal, right or and so on. Dr Townsend, you know, What’s your philosophy with that? If someone comes to you for any treatment, maybe it’s a crown, maybe it’s an implant or a denture. You know, when they don’t quite respond like we wanted their body to respond, what do you do there?

Dr. Tanner Townsend 0:37
I think the overarching theme of what we try to do, and I think I’ve learned a lot from you in this aspect of we just try to make it right. Now, sometimes we don’t know necessarily, if it’s just the patient’s body responding poorly, or if they were biting down on their implant before it was fully healed, or chewing on something that they shouldn’t necessarily, or it was just something during the surgery that didn’t go the way we wanted it to. But regardless of what the modality was for why something’s not going right, we have a philosophy of, we’re just going to make it right and we’re going to fix it and take care of it. And I think that is a nice thing to help reassure patients that, hey, we’ve got your back. We’re going to help you out any way we can.

Dr. Josh Muir 1:18
Yeah, that’s it. You know, I had a patient this week who we did a denture for, and the denture broke just through normal eating. Well, obviously, that’s not supposed to happen. And so they were really worried about it. You know, they had already paid for it. They don’t want to pay again. And so we said, hey, come in. We’re going to make a new one for you. We’re going to ensure that it’s bolstered up so it’ll be stronger this time. We’ll even put a metal framework in it to help it increase in strength and last better for you, and we’re not going to charge you more for it. I mean, what a relief that is. And they were very relieved. So yeah, we do want to help patients get the treatment that they need. And whatever treatment we do, obviously it has to last. What have you seen happen as far as patients that don’t follow instructions?

Dr. Tanner Townsend 2:09
What do you mean in particular?

Dr. Josh Muir 2:10
Meaning you’ll tell someone, hey, we just placed this implant. Leave it alone. Don’t chew on it. Just leave that side of your mouth alone. Chew on the other side for the next three months or so. What happens when they don’t

Dr. Tanner Townsend 2:25
Well, I think there’s a variety of things that that can happen. The worst possible thing that can happen, if it’s an implant, they’re chewing on that implant, that implant can fail, meaning it’ll become loose. Oftentimes, if I see a patient that does that, the implant will become loose. It’ll become painful when they’re kind of biting down on it and potentially infected. And so usually that’ll happen within the first couple weeks of placing the implant. Typically doesn’t always happen that way, but it typically does. That’s what I’ve seen. And so oftentimes we’ll lose that implant and we’ll have to start from start all over again, which is a real bummer.

Dr. Josh Muir 3:00
And it’s, it’s hard sometimes to know why something doesn’t work. I mean, we’re dealing with the human body, which every body is different. And so sometimes I’d like to say, Hey, man, I know you were chewing on that, but do I really know? Probably not, you know. And so

Dr. Tanner Townsend 3:18
Sometimes there’s a lot of signs that point that way, but it’s also that patient management side of educating, but also saying, Hey, we, we are working on this together, right? You know, I’ve done my part. I need you to do your part as you’re healing, to take care of it.

Dr. Josh Muir 3:32
Yeah, I’ll often, when a patient comes back for just evaluation or to remove some stitches, I’ll say, so. So how has it been? Is it pretty nice to chew on? And I try to trick them into giving themselves away. And with the answer I’m looking for is, oh, I don’t chew on it at all. You told me I shouldn’t chew on it. I’ll say exactly. Thank you so much. But every now and then someone will say, Oh yeah, it’s been great. I can chew anything on it. I don’t. I don’t even hesitate. I chew nuts, I chew pizza, I say, okay, and now remember not supposed to chew on it. Yeah, we’re gonna evaluate it today and make sure it’s healing well. But if it’s not, that’s probably why, and I’m not gonna say that it’s 100% someone’s fault, because we’re the ones educating them. We’re the ones helping them understand. Here’s what we expect of you, don’t chew on it. What that means is, don’t chew on it, you know. And so or chew only soft foods. Well, what are soft foods? Like chips? Well, no, those aren’t soft because, remember, they’re crunchy. And people say that I wasn’t chewing anything hard. I was just chewing chips like, well, chips are a little bit hard, you know. So if something goes wrong, even though they broke the rules, what do we do? I mean, what do we do in that case?

Dr. Tanner Townsend 4:48
In that case, I’ve just helped people and said, hey, we’ll fix it. We’ll make it right. But we do need you. If you’re gonna want a good long term outcome, you’re gonna need to take care of this thing. And so I think it comes with a little bit of kind reprimanding, in a way, but also letting reassuring them that we’ll take care of them and work with them.

Dr. Josh Muir 5:07
Yeah, exactly. And sometimes I’ll say, Look, you know, I think you’ve been chewing on it, whether you realize it or not, or you’ve just been playing with it with your tongue over and over and over while it’s trying to heal. Well, let’s do it again. What we’ll have to do, we’re going to have to take the implant out. We’ll have to do some bone grafting. We have to let that heal. We’ll put another implant in. Now, if that one fails, there’s something going on here, because implants are very successful, and so that’s where we really have to reevaluate. But we don’t charge them more. We work with them, we educate them, we educate them, we educate them, and we move forward together. And as long as the patient is working towards the end goal still, then we’ll keep working towards that goal with is that pretty accurate?

Dr. Tanner Townsend 5:52
Yeah, I wouldn’t have said it any different myself. Well, anything you want to add to that, not in particular, I think, yeah, yeah. Anything else we want to add?

Dr. Josh Muir 6:02
Bottom line is we want to help people get the treatment that they need. And if we’re doing treatment, we want it to be successful. So if we encounter some obstacles along the way, some healing that doesn’t work quite right, or even if there’s a misunderstanding on what’s expected during that healing process, we’ll take care of them. We’ll work with them, and we want the treatment to be successful.

Dr. Tanner Townsend 6:24
I love it

Dr. Josh Muir 6:25
Sounds great. All right, thanks for joining us today. Have a Good One.