You Are Special And So Is Your First Appointment With Me

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My ultimate goal is to provide the very best care for my patients and no effort is too great to achieve that goal. Therefore, a patient’s first dental visit to my office is quite involved. It can be up to ninety minutes or more. All healthcare professionals are supposed to adhere to strict codes of conduct, and I am no exception. The reasons are due to legal standards and more importantly on ethics. I must do my very best to listen to the patient’s concerns and expectations, carefully examine the patient and hopefully observing every detail, and above all, cause no harm.

The first appointment has three components: Preliminary paperwork, the exam, and a cleaning. I am including the paperwork as part of the visit, but technically it is separate and can be done prior to the actual visit. It may not even involve paperwork, as the forms are found online, or can be emailed. The exam and cleaning can happen in whatever order the schedule allows.

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I have a special group of staff dedicated to guiding new patients through the initial stages. I have a “request an appointment” button on every page of this website that links to the Dental Associates of Ct. site, of which I am one of the principles. Once a patient is on my office’s website ( a live chat will pop up and that patient can be assisted through the entire process of choosing an appointment time, and giving information regarding insurance. We can discuss finances and send the health questionnaire and HIPPA forms as well. This is the easiest way to make an appointment, but you can call any of my offices and the same thing with a treatment coordinator who can also email the forms, mail them, or tell you how to download them from the internet.

I prefer to have the health questionnaire ahead of the appointment date, as I like to study them in detail, and this takes time. I can gain insight into the patient’s things like health conditions, chief complaints, and any special concerns. Each patient comes with a unique set of issues, expectations and desires.

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The cleaning takes an hour. The hygienist reviews the health history and asks about the patient’s specific needs and concerns. A thorough exam is done, and the condition of the gums is noted in the chart. This is referred to as periodontal charting and consists of 6 different measurements around each tooth that reflect how deep the small crevice around the tooth is. They also note other conditions such as bleeding or recession. If the crevice is deeper than 4 millimeters, the patient is considered to have periodontal disease which usually requires additional treatment. If there is periodontal disease, a special cleaning with local anesthetic (called root planning) is recommended. You can read about gum disease in my previous post here.

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After the exam and charting, the cleaning is performed. Plaque and tarter deposits are removed with special instruments called scalers. In addition to the scalers, an ultrasonic unit can be used to facilitate the removal of deposits and staining. Finally, the teeth are polished. Sometimes a patient has too much debris to clean off in one visit and another is needed. The hygienist will relay to me any pertinent information about the patient’s status, disposition and concerns.


I start my portion of the appointment by chatting with the patient, keeping in mind everything I have learned about them from their health questionnaire and the hygienist’s assessment. The time frame for this portion is about forty minutes. I do a quick exam to determine which digital x-rays are needed. You can read about x-rays in my previous post here. After the digital x-rays are taken (technically known as the radiographic examination), I do an examination using a special dental microscope throughout the entire exam. I also take digital photographs. My assistant and I enter a detailed analysis into the digital chart.

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If there is not too much going on, I am usually able to go over everything with the patient at the end of the visit. If there are many issues present. If the treatment is more involved, I usally set up one more appointment with the patient. This allows me adequate time to carefully review everything and generate a plan of action for the patient, along with any viable alternatives I can think of (this can take forty-five minutes sometimes). This special appointment is called a treatment explanation and is about a half hour long, with additional time spent with the treatment coordinator to discuss insurance, fees and payment options. Finally, when we all agree on the treatment plan, the next appointment is set up and we can finally get going on the actual treatment…whew!

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We are all busy, so I understand why patients don’t want to spend that much time in my office. My goal with this post is to enlighten people of important their health is to me. It is best not to rush something so important.