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Professional Courtesy: Want to Remember Something? Write It Down! Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine

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Want to Remember Something? Write It Down!
by Thomas Giacobbi, DDS, FAGD, Editorial Director, Dentaltown Magazine
The memory of our patients cannot be trusted. If you learn this lesson early in your career it will serve you well until the day you retire. Ask any dentist who has been in practice longer than 10 years if they have ever cringed at the following sentence: “Doc, this tooth didn’t hurt before we started working on it.” A higher percentage of family members, relatives and neighbors will say this phrase, but it can be anyone. The classic example is a case of cracked tooth syndrome. The patient exhibits occasional pain with biting, some sensitivity to cold, but the symptoms are not consistently reproducible. The appropriate treatment is often some form of cuspal coverage restoration – an onlay or a crown. You must remember to fully inform patients how their tooth might feel after the preparation and that a root canal could be in their future. Frequently, they will only remember the part of the conversation where you told them that the crown alone may fix their problem.

My recent experience with selective memory happened when I treated a neighbor for a cracked tooth on #18. He came in days before his family vacation with a chief complaint of pain on the lower left with chewing. This was intense enough for him to return to our office after a two-year hiatus. We were able to duplicate his symptoms with a bite stick, and a crown was recommended. I was concerned enough that he would get worse before returning from vacation that I provided a prescription for pain medication and antibiotics if things worsened while he was on his camping trip. Thankfully, he did not need the medication and he returned for the crown preparation two weeks later. You can guess where it went from there. His tooth felt fine in the temporary but he still had some discomfort chewing nuts. The tooth had plenty of time to settle down but it was not 100 percent, so I sent him to the endodontist for evaluation and treatment. The endodontist confirmed my suspicions and recommended a root canal. My neighbor called me to say, "I'm still not convinced," and that his tooth had been doing pretty good. This was the point at which he dropped in the phrase I mentioned, "I don't understand, it didn't hurt before."

Rest assured, my notes at his original visit include the discussion of root canal in addition to the crown and the fact that the need for a root canal can sometimes happen years in the future. Patients that want to challenge my memory need only to read the clinical notes from their visit for a refresher. This is some of the best advice I can give to you as a young dentist or dentist to be. The quality of your dental treatments includes the qualities of your clinical notes. Many times after we have done so many crowns and fillings, we can become careless with our notes. Please remember this story and be diligent with your efforts to document clearly and concisely. As you start to practice in various offices or you start one of your own, you should learn how to create templates for clinical notes in your practice management software. There is a twofold advantage to this feature. First, you will never have an issue with legibility if you are using your software for notes instead of a pen, and second, this will automate the mundane details of each appointment, leaving you with the task of just filling in the details. If you are still writing notes with pen, make an effort to stop soon as memory is fleeting and clear handwriting is rare.

Best wishes for success in your chosen profession. The rewards will match the challenges. Please feel free to drop a note if you have any questions or would like some advice from a fellow professional: tom@dentaltown.com.
Dentaltown Magazine
October 2025
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