“Because We Felt Like He Needed His Teeth Cleaned”

119833964The other day a patient came in for his bi-annual routine hygiene cleaning,  sat in the chair and told our hygienist, “I don’t need my teeth cleaned today, the implant doctor did it last week, I just want to see the Doctor.”

Our hygienist was not sure what to think, she was shaking her head as she told me about it. “He said the implant doctor said he needed his teeth cleaned and just started cleaning them, charged him for the cleaning, so it doesn’t want it redone but they didn’t do a good job, I can see plaque and gunk on his lowers.”

“ARE YOU KIDDING ME?”  were my first thoughts, but I wanted toangry on phone large know for sure if the Doctor who was going to place an implant for him would just go ahead and clean his teeth without even asking him if he has an appointment with his general for that, so I gave his office a call. Sure as shooting, they did. Our patient went in for implant and the Periodontist said “we’ll clean your teeth first” didn’t give the patient a choice or a chance to say, “I have an appointment.”

Let’s be fair maybe there was gunk and the doctor needed to get it out of the way before he could do the implant. OK, I get that but he could have just cleaned around the implant area, and not the entire mouth, adding extra charges for a teeth cleaning.

 And if he did, he could have called our office and let us know.

THAT was my issue when I spoke to his Office Manager; I let him know that I was pissed. I bluntly told him, “You could have called, you could have sent a report, it has been over a week. I could have moved that patient to the Doctor’s schedule for him to chat with doc and not paid my hygienist to do nothing. And this put her in an uncomfortable position, having to cover for your office doing a poor job of cleaning our patient’s teeth.” (we weren’t going to throw anyone under the bus and tell the patient his teeth were not very clean.)

The Office Manager’s response “do you want us to send you a check?” I almost hung-up.

Our patient had other issues with this Doctor, he said he did not speak very nicely to his assistant during the procedure; our patient does not want to go back. He was not impressed and nor was the Dental Office, so we probably won’t refer to that Doctor anymore.

This specialist has forgotten that his level of customer service must match ours and that he doesn’t call the shots. We feed him by sending him patients, so he needs to communicate his intentions to us, not make decisions about our patients recall.  We can always refer our patients to the special down the block!

With your success in mind, 



  1. Dr Gary S. Ford, DDS, AEGD-2 yr residency, MAGD | | Reply

    A very frustrating situation to say the least and for the most part, I agree with you…however, as a DDS who does referrals from at least 40 referring dentists, I must make a correction in your “rant”. That the specialist “does not call the shots”. I do call the shot. I have to, since I will be the one answering to the patient when things “go wrong”. I take any referring DDS’s treatment plan “under advisement” and then I make my own treatment plan and notify the patient if they are any changes to what was originally proposed, explaining what I found and why there was a change. My shot, not yours. I always follow this up with a letter to the referring dentist, explaining why there was a difference. By the way, most of my referrals are – just do it and then they give me the worse possible copies of the poorest radiographs you have ever seen…frustrating to say the least.
    Warmest regards and keep up the fantastic work,

  2. Kate | | Reply

    I think that the specialist has forgotten that he has two customers – the patient and the general dentist. He can’t afford to piss either one of them off.

    It’s experiences like this one that make me glad that I live in an area with multiple specialists so I can match the right patient with the right specialist.

    BTW – I have trouble reaching your site on my phone. I switches to nomiwaters.mobi and then the link broken sign comes on.

    • Nomi Waters | | Reply

      Thanks Kate! I am working on the mobi problem, thanks for letting me know.

  3. Beverly | | Reply

    So, as a specialist office, I will weigh in. First, let me say that I am in no way an advocate of what and how your referred-to-specialist office handled this. That being said, I see this situation in reverse so many times. The patient arrives for an implant and/or other isolated procedure and they are a mess. Their hygiene is so out of control, it is impossible to provide the care that is best for the patient and give them the best result due to the poor hygiene care they received in the referral office’s hygiene department. There are really only two options. #1- clean the patients teeth for free, and provide the referred for service. Contact the GD office and let the doc know. Maybe he doesn’t know about the poor hygiene care his patient is receiving from his hygienist, or more likely, the patient has not been fully cooperative or honest about how often he/she is actually receiving services. Patients tell us all the time, “I just had my cleaning”, only to learn after a quick call that they haven’t been in for routine hygiene in a year or longer. #2- contact the GD office and find out when they are scheduled for hygiene and perform the surgery a day or so after that visit. BOTH options have one common element. COMMUNICATION with the GD office. Just as we have to have communication with our patients, we have to communicate with each other to ultimately have the BEST outcome for our patients. The TEAM (Together Everyone Achieves More) approach works best not only with the doctor/patient relationship but also the doctor/doctor relationship.

    • Nomi Waters | | Reply

      Amen Beverly! THAT was my issue with this office, the lack of communication, each party can not work together in the best interest of the patient without it. NOMI

  4. The Dental Warrior | | Reply

    Your doc needs to call the specialist and let him / her know why they won’t be getting any more referrals.

  5. David Moffet | | Reply

    Sadly, I’ve seen this happen down here as well.

    When times are tough, it appears that some specialists can’t resist temptation.

    I’m in full agreement with Michael Barr. Start referring to a different specialist.

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