Why you need to tell your patients the truth

March 3, 2017
Ethel Hagans, RDH, MBA

Ethel Hagans is a dental hygienist first, and then, the author of the book Extraordinary Dental Care. She is obsessed with motivating hygienists to raising their level of care, in order to woo their patients into patterns of great oral hygiene. Her motto: “In the end our main goal is to make sure their teeth outlast them!”

Being the bearer of bad news can be an unpleasant yet necessary part of the job.

Studies by the ADA show that almost half of adult patients suffer from gum disease, and these numbers will only increase with age due to decreased dexterity or medical health. So if you notice bleeding or areas overlooked in the patient’s daily routine, let them know because without doing so areas of localized plaque, mod. stain or light calculus will only worsen or return with every follow-up visit.

To slow down bad oral hygiene or to stop it completely, often it simply takes making the patient aware. I would even go about bringing him or her in more often. Most patients will agree to a shorter recall if it grants them the opportunity to keep their teeth. As dental professionals, it is our duty to make sure they know the condition of their oral health. It is not just a cleaning anymore, so tell the truth.

Educate your patients

I will never forget having an elderly man who said he simply wanted a “buff and puff.” At the time I was confused as to what this meant. He only had six teeth on the bottom arch and an upper denture, so in my mind he couldn’t afford to lose anymore. The gears in my head soon began to race as I thought, if only I had seen him 20 years ago I could have helped change the condition of his mouth and saved more teeth. Maybe he would have just a partial on the upper or maybe even still have all of his teeth if only someone had simply told him the truth about his condition. Despite the damage already having been done, his six teeth were still important, so I gave him all my dental hygiene skills to make sure that his few remaining teeth would outlast him.

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Sometimes telling the truth is not always easy, but it is necessary. When doing so, stand firm and show the patient brochures and X-rays to further back up the diagnosis. The more you educate them, the smarter they become. All patients will applaud your honesty - no matter how hard it may be - and appreciate the fact that you care.

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View yourself as a coach

Another patient I had was named Steve. Steve was from a small town and had attended high school with his old dentist. They also used to sometimes run into each other while having coffee at the local town diner. Unfortunately soon after meeting Steve, I discovered he had gum disease, and so I had to be the bearer of bad news. After the new dentist confirmed the perio-diagnosis, I relayed the news to Steve, and boy was he angry. He exclaimed to me, “How could my childhood friend not tell me!” I preceded to tell him that some dentists have a problem discussing perio-disease symptoms and will wait until it is serious enough to refer to the periodontist, at which time it is already too late. It being Christmas season, Steve furiously explained how he could not wait to go back to his hometown and knock his friend out for not telling him he had gum disease. I immediately replied, “Please, don’t do that!” Lucky for him though, he was only in the early stages of perio-disease, and I assured him we could get him back on track to good oral hygiene. I proceeded to do a deep cleaning, and he agreed to come back after the holidays to follow up with a fine scale and polish.

In January Steve came in, and I could not wait to ask him if he had met his old dentist at the diner and slugged him one time. He laughed, and said yes, that he had seen him at the diner through the window, and so he decided to pick up his coffee at the gas station down the road instead. We both had a good laugh and I performed his cleaning, which revealed that his oral hygiene had improved. He also stated that he had received an electric toothbrush for Christmas and loved it. It just so happened to be the one I had suggested to him. In the end I was so happy for Steve because I knew his teeth were on the right track. This is just one of many stories, but your goal should be to both encourage and coach every patient to do better. It doesn’t have to be major and could be encouraging just a little change, such as switching to an electric toothbrush or a different toothpaste.

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Use friendly competition to your benefit

For others, competition is a motivator. I had a young, married couple that always came in together and would compare notes on who had the better teeth. I saw the husband, Jack, first; he always had perfect oral hygiene. Then I saw his wife, Amy, afterward. She was a cute little thing, and you could tell her looks were very important to her. She always dressed nicely, with her nails and hair done to perfection. While in my chair I could see that she had several areas of bleeding and some localized tartar, and so I asked her if she used the electric toothbrush that she had gotten for Christmas. She explained that she was not a fan of it. I then told her, “Amy, Jack’s teeth looked excellent today, and he loves using his electric toothbrush. What are you going to do when 50 years down the road he still has his teeth and you don’t?” She replied, with all the innocence in the world, “I will reach over and knock his out!” I gasped and said, “Amy no, that is not the answer!” We both laughed out loud. She then stated that she was just kidding and that she would give her electric toothbrush another go.

Though the truth may often be hard to swallow, by bringing it to light something can be done about the issue. Little changes can make a big difference, but you won’t know if don’t go out on the limb and say the things that are often left unsaid. For those who are not honest with their patients, they are doing nothing for them other than a disservice. So rise above the crowd, even if it means being the bearer of bad news, and don’t forget - in the end our main goal is to make sure their teeth outlast them.

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