Can I wait until next year?

This time of year I hear this question just about every single working day. And, this may surprise most of my dental peers – but my answer is always "Sure." In our dental family, our patients are always in control of their treatment. So, to wait until next year is ultimately their decision. This is the season for utilizing insurance benefits if they remain – and making the decision to wait for benefits to renew if this year's benefit has been maximized. There are times; however, I feel this is not the best advice.

1. When treatment needs exceed the allowable for next year, too. Insurance allowable benefits have remained the same for decades. Literally. We are starting to see some annual benefits creep up, but they were so far behind on the cost of actual dental treatments the difference is negligible. If insurance allows $1500 a year for dental treatment and the remaining estimated cost of treatment is $3000 there will be an additional out of pocket expense. In these cases to wait doesn't gain us any financial benefit. It is better for our team to find a way to spread the estimated cost into balanced payments so that our patients can get the treatment they want, need and deserve.
   
2. Postponing treatment jeopardizes outcome. Often patient's have advanced disease that needs immediate attention. Cases such as deep decay, painful gum infections and painful toothaches. Mouth pain most often is related to bacterial infection. Bacteria live and thrive in warm, dark places like under the gums and inside teeth that have been weakened by decay. This pain can be relieved with the use of antibiotics. But, seldom is the source of the infection alleviated and once the antibiotics have run their course, the infection quickly returns and often with much nastier results. We live in a world where we hear about drug resistant strains of bacteria developing. And this is how it starts. We have an infection; we reduce the infection with the antibiotics. But, since we don't remove 100% of the bacteria, some of those are likely to be resistant to the antibiotic. When the medicine kills all the bugs that are susceptible to that particular medicine, only the resistant ones are left to infiltrate the infected area. We get bigger, meaner colonies of bacteria. And these are harder to alleviate later. So, in painful situations directly related to bacterial infection, I will follow my "Sure" answer with a "but….".
   
3. It's been years, Doc. Wow. I honor and appreciate those folks that have worked up the nerve to get to the dentist after years of fear. This is similar to a fear of flying – or falling off a horse. Many times to wait another three months will put this person right back in the holding pattern they just overcame. Finding the right steps to take for this patient are critical in making sure they proceed toward complete treatment. In these instances, let's make a plan to bite of a little at a time and keep taking small steps forward.