"When you had your lip augmentation, did the doctor say you needed to be concerned with any impending dental care?"
Updates to a patient's medical history are important facts we need to know before proceeding with any dental care. When a 20-something patient came in last week, we asked the question about health history updates and she said nothing. Her lip augmentation was more than obvious as the uniform enlargement of her lips was clinically apparent.
Sheri B. Doniger, DDS.Some may say this is a perfect lead-in to other aesthetic procedures, such as teeth whitening to orthodontic teeth straightening or minor tooth movement. We were more concerned that she didn't inform us (although it was highly evident) that she had a procedure. It is so important to find out health information from patients, even if they think it doesn't matter when getting their teeth "cleaned."
Several weeks ago, we had a patient who was breathing more rapidly than usual. He had some health issues and was not a fearful dental patient. We questioned him during the appointment, but he said it was nothing. We stopped several times, but he did not ask for us to change our treatment or complain about the dental work.
After the appointment, he disclosed that he had fallen, broken a few ribs, and cracked a vertebrae. His difficulty breathing was a combination of the summer pollen season and the pain when he was trying to inhale. Again, this is another example of when the patient did not feel it his health history was relevant to his teeth. Interestingly, his wife came in and described the falling incident with more graphic detail. She said they had to call 911.
The young woman who had lip augmentation was more forthcoming at her restorative appointment. She said her friend was working as an assistant in a dermatologist's office and they were doing lip augmentation treatments. So, she took advantage of the "discounted" procedure. She was a little embarrassed at the actual size of her lips, so she did not want to tell us (aside from it being obviously evident).
From lip augmentation to serious injuries, we need to discuss the importance of our patients sharing their health information. The anesthetic may need to be changed or procedures need to be altered. Instituting a three-person system of asking about patients' health history updates is a wise option. Documenting patients' responses, in case they do omit something important, is critical.
Sheri B. Doniger, DDS, practices clinical dentistry in Lincolnwood, IL. She is the immediate past president of the American Association of Women Dentists. She has served as an educator in several dental and dental hygiene programs, has been a consultant for a major dental benefits company, and has written for several dental publications. You can reach her at [email protected].
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