I had a patient in the office today for an adjustment of his anterior bite plane appliance. When I came in and asked how he was doing he said “great, but I think I melted my mouthguard”. Curious I asked if he had it with him and he reached in his pocket and pulled out a melted remnant of his anterior bite plane attached to the composite. As we looked at it he said “I’m not sure what happened, I followed the directions and only had it in boiling water for 45 seconds to try and tighten it.” For years I have shared the instructions with my patients for tightening their own anterior bite plane appliances at home, this is the first time I have had a patient melt one. I guess that isn’t a bad percentage, but it has made me rethink post-op instructions and how to help them be more clear.
One of the first things to decide is whether you will give post op instructions verbally or in writing. There are pros and cons to both of these methods, and I know many offices in both camps. Either way your chart notes should reflect that post-op instructions were given. Over the years I have come to appreciate the value of written instructions, especially when my kids have had an accident or been sick. It surprised me at first, but now I have come to accept that when I get home I have trouble accurately recalling the instructions. This is especially true when I have been worried or stressed during the instruction period. I think this is often the case for our patients. They are not fully present when we are explaining in detail all the things for them to do at home. Most of the time, there is no one else with them who can help recall the instructions.
Lastly, for many of our patients they are hesitant to call and get clarification, so instead they do what they think they remember. With all this said, I guess written instructions seem to make more sense, especially for complex issues like appliance therapy, endodontics and extractions. For everyday procedures like composite fillings or seating a crown, I give the instruction verbally. I also think this mix, lends importance to the times I give the patient something in writing to take home. I’d love to hear any other input on what people are doing in their offices.