Howard Speaks: Make a Different Kind of 5-Year Plan by Dr. Howard Farran

Howard Speaks: Make a Different Kind of 5-Year Plan 

by Howard Farran, DDS, MBA, publisher, Dentaltown magazine


One of the biggest mistakes I made as a young dentist was how I approached my treatment of elderly patients. When you’re 25 and fresh out of dental school, you see an elderly patient and think, “Man, that guy’s not going to make it until Christmas! So I’m just going to patch things up and not do anything too big on him.”

When he showed up again the following year, though, my patchwork would be all broken out and then he’d need a root canal and a crown. I had one patient I started treating at age 90 who was still alive at 103! That’s nearly 15 years of treatment that, frankly, kinda short-changed him.

Learn from me: Everything in your treatment plan should be ready to last at least five years, no matter the age of the patient.

The great graying of America

Americans are living longer—over the past 100 years, the average life expectancy has jumped from 53.22 years in 1920 to 77.80 years by early 2020. The Federal Interagency Forum on Aging-Related Statistics estimates that by 2030, there will be nearly 72 million U.S. residents who are 65 or older—nearly 20% of the population! And although this age group is more prone to conditions like xerostomia, periodontitis and untreated caries, that’s no reason to short-change their treatment plans.

In our October issue of Dentaltown, Dr. Joe Whitehouse shared a case study that illustrates the importance of asking about—and listening to—the level of treatment elderly patients are actually interested in pursuing. Toning down the treatment plan to fit the dentist’s view of what the patient can afford robs that patient of the ability to make an informed decision.

Today, many baby boomers are retiring with a full set of teeth, and not every elderly patient wants to end up in full dentures, especially when other options exist! As one dentist told the Academy of General Dentistry:

“It’s much more common nowadays to see a 65-year-old wearing braces instead of dentures.”

Reserve your patchwork for quilts

I did a quick Dentistry Uncensored video today with Don, a patient who’d come in with a broken tooth. I told Don: “I can either take you to the vet and have him put you down, or we can figure out a treatment that’s going to fi x things up and last for years.” Not surprisingly, he opted for the latter!

Now, I’m not saying this because I’ve now reached the age of being an elderly patient myself. (Or at least I’m not saying this only because I’ve reached the age of being an elderly patient myself.) Learn from my mistakes! If your treatment plan won’t last five years, don’t do it. Your patients—yes, even the ones who are senior citizens—will appreciate it.

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