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How do you address patients who are overdue for their recall?

An issue that comes up often for me is patients who are overdue for their recall. Of course all patients’ needs differ, but sometimes whether they’re a couple years or just a couple months past their recommended frequency, I am unable to meet all of their needs in the 1 hour recall appointment they’ve been booked for. I find that patients are often surprised and unhappy about this. They make comments such as their previous hygienist always being able to complete their treatment in one visit, or insist that their teeth are pretty clean, etc. With further discussion and patient education I can usually get them on board, but I would like some tips on helpful things to say. For me, in addition to explaining the health-related reasons I recommend they return for further treatment, I also say things like ‘Being two years overdue is the equivalent of missing 4 appointments. I simply can’t accomplish the work of 4 appointments in just 1 visit’. Sometimes I find it difficult to balance what is ethical (having time to update all necessary records and complete thorough debridement) with the aim to please (avoiding a disgruntled patient.) Also, I fear that if I were not to recommend additional appointment(s) then I would not only be neglecting proper care, but also teaching the patient that it’s okay to be overdue and that I’m able to accomplish treatment once a year even though I’m recommending twice, and then we get into a cycle of never catching up. I would like to know how other hygienists deal with these situations. What verbage do you use, and at what point in the appointment do they break the news that they will not be able to complete treatment in the time alotted?
Thanks in advance for any input.



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3 Answers

Sounds like you have great verbiage already. Educate until you pass out. They will come in when ready. You can only do what you can in the allotted time…..what else could you do?

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Our office, and myself individually handle this in several different ways. I will start working and ask the patient if they like to be informed or not so much (mainly because I have a history of over informing and for those that don’t like it they get a bit scared) I walk them through all the findings that I have and try to make sure they understand that even the best homecare doesn’t always prevent build up and caries. most of the time their insurance covers the extra appointments, but the ones whom say “my teeth are clean I don’t feel like I need to come in every six months” I tend to say “Caries can build up over a six month to a year period depending on the person which is one of the reasons we like you to come in, our goal is to prevent issues not just fix them when they arise” – my doctor has dismissed a couple patients though on the basis of them not following through with treatment including regular recalls but we tend to see a lot of drug seeking patients. Hope this helped.

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Every office and clinician will vary on how they handle this. Fortunately I work in a fantastic office with great support from doctors and front office. It is our office policy that any patient that has not been in for 2 years or longer, are considered a NP and are told they will not get a “cleaning” until their perio status has been evaluated. If they have a healthy mouth without perio and time allows we will do the prophy. If not it will get rescheduled.

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