I heard a story once of a dentist that got a phone call from a colleague telling him about a patient he was referring. It was a heads up call to let the dentist know that the patient was elderly and could be a challenge Not long after that the patient appointed, the dentist happened to see the patient as she was completing the medical history form while standing at the reception room counter. The dentist thought that the patient, who appeared frail and unsteady on her feet, must have been at least 70 and would require a careful medical history review for chronic disease and possible implications of multiple medications.
As the patient was publicly completing the medical history form she actually read each question out loud to herself and anyone within earshot. “Have you ever had anemia? Yes.” [she checked the box]. “Have you ever had arthritis” Yes.” [she checked the box], “Have you ever had asthma? No.” Have you ever had heart problems? Yes.” [she checked the box]. “Have you ever had …..? on and on checking a few boxes. The dentist was a little relieved not to have heard too many problems.
Imagine the dentist’s surprise when the patient got to the question “Have you ever had pneumonia?” she raised her head and thought for a few seconds and then turned around and to someone completely out of sight of the dentist and hollered “Now, Mother, when was it you had that pneumonia?” We all know that’s a true story.
Patients like this daughter and her mother are becoming more common. People are living longer with acute and chronic diseases and taking multiple medications. In 1900 the average life expectancy was 50 years. In the 20th century mortality rates began to decline in the older population and the quality of life for this group continues to improve. Today it is more than 80 years. According to a January 2015 report people aged 85 or older constitute 8 percent of the world’s 65-and-over population. In many countries, the oldest are now the fastest growing part of the total population.
What are the implications for dentists when managing patients taking medications for diseases? How can helpful information be provided to make the delivery of dental care safer and at the same time give the clinician more confidence? These kinds of issues become more pressing as the population continues to age.
For instance, dentists need to have answers to important questions like:
-Does the patient have stable or unstable disease?
-What are the pharmacology considerations in treating this patient
-Are there multiple diseases present and how does the physician consider this management?
-Is my patient at risk for bleeding because of the disease?
-Is my patient susceptible to infection because o the disease?
-Do I need to modify my standard procedures?
In fact, awareness of these issues is central to the approach of the Clinical Team of Dental Symphony. We created a library of documents and resources that are designed to address these questions when treating patients who have diseases and taking medications. The table of contents for Dental Symphony Point-of-Care information follows a standard analysis:
These resources are created and provided for the clinician when patients complete the registration process, and tailored to each patient is a wealth of knowledge tapping into the formative learning experience of clinicians. Accessing this specialized information helps reinforce understanding and decision making.
Given the population trends occurring, dentists face more and more clinical situations that require asking the questions listed above. We are excited to help meet the needs for the modern clinician.
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