"I'm taking care of a very healthy woman with two kids who is a teacher and who's now cracked two teeth," Abrams said. "You've got to go back and ask the first question of, why did it happen? And why did it happen now, and what would be the driver to cause this fracture?"
In this case, the patient told Abrams she cracked her tooth when she bit into a nut. But Abrams was skeptical, so he paused looking in her mouth and instead asked two other questions: How are you doing? How are you feeling?
As the patient started talking, Abrams learned that she was worried about school beginning at the end of June -- both for her job as a teacher and for her kids. She'd also noticed waking up with a stiff or sore jaw in the morning.
"The biggest challenge in all of this is getting the patient to accept that, 'Yes, I am grinding,' " Abrams said. "The final, bigger piece is, 'Yes, I am stressed, leading to grinding, leading to broken teeth.' That's three big steps, and it takes time."
That could have been the end of the conversation, but Abrams didn't want to help just by addressing the effects of the grinding. He wanted to get to the root cause. So on each patient visit, he also worked with the teacher to come up with ways to cope with the stress.
"Moving away from the dental piece, I'm now looking at the entire human being," he said.
And for Abrams, the patient's care didn't stop when her treatment did. A year later, he is still following up with her by email to make sure she's doing OK as the new school year approaches, because "it's the nice thing to do."
Abrams also emphasized that asking these types of questions and helping patients come up with a coping plan doesn't have to take long.
"Instead of talking about the weather, we're talking about whether they're coping or not," he said.
Learn more about the tools and techniques Abrams has used to help patients with cracked teeth during the COVID-19 pandemic in the video below.
You can reach Dr. Stephen Abrams at firstname.lastname@example.org.
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