Easing into oral care therapy compliance

Nov. 16, 2012
This morning I had a patient whose tissues showed remarkable improvement from the last time I had seen him ...


This morning I had a patient whose tissues showed remarkable improvement from the last time I had seen him, which was on an initial visit six months earlier. I was very enthusiastic during the chairside visit, offering accolades and all sorts of enthusiasm. He had started to floss on a regular basis. When I questioned him about what he was doing differently, he turned and looked me squarely in the eye, and said, “I didn’t like getting yelled at, so I started flossing.” Ouch! I felt like I’d been kicked in the stomach.

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It reminded me of a time, several years ago, when I overheard my 16-year-old daughter on the telephone with her girlfriend. She said, “My mom yelled at me about my outfit, so I can’t wear that anymore.” Overhearing that telephone conversation was another sting.

Let me be clear, here. I most definitely do not yell at patients for not flossing their teeth. I try to do my job — present information as needed, give positives where I can, recommend alternatives when possible, and basically say, “Do the best that you can to be healthy.” Neither would I yell at my daughter. Most likely, I firmly told her what was acceptable.

Last spring, I left my hairdresser for several reasons – scheduling being the major conflict. But one thing that always bothered me was that at every haircut she would criticize me for cutting my own bangs mid-cycle. It was always about what I had done, and how badly I had done it. How did that make me feel? Like a big zero! As I said to a girlfriend, “I’m tired of being yelled at, and I’m going to find someone new.”

The truth is, Donna didn’t yell at me. I shouldn’t have cut my own bangs. I am not a hairdresser, and I probably made it difficult for Donna on the next visit – but look at the outcome! Ultimately, I left her and found a new hairdresser. My new stylist is aware that I cut my bangs mid-cycle, and she teases me gently, gives me tips, and tells me it’s all going to be fine because my hair is wavy anyway. She then puts her hand on my shoulder and says, “I’ll fix you!” It is music to my ears, and I always look forward to coming back.

Many times, patients leave our treatment rooms and walk to the front desk, where the administrator asks about their visit. They reply, “I got yelled at because…” You are probably starting to see where I’m going with these analogies. As hygienists, how do we find that balance? How do we walk that fine line between educating, and not chastising, those who sit in our chair?

(Sidebar: Maybe we need to simply accept that what folks refer to as “being yelled at” is not necessarily that, but merely their way of labeling criticism, however positive and helpful the message was intended to be.)

Here are some of the things that I do to soften the blow when I am delivering constructive criticism chairside. If noncompliance with flossing is the problem, I might tell a patient that I don’t floss as often as I should, although I know I should be the role model. (This is true by the way.) I demonstrate the use of Soft-Picks, and state that they are a great substitute. Honestly, if my patient is flossing a few times every week, I am truly happy, since so many will not floss at all. I might chime in with “That’s great, and for now, you are getting away with it,” and give them a big smile. This may not have been the educational message I would have delivered in my twenties, but it’s a mature, seasoned message.

The same thing goes for patients that stay away too long. Coming across as judgmental or scolding on this one guarantees a repeat performance. Instead, how about a light, sweet “I’ll fix you,” (like my new hairdresser says), then, in closing, “You are back on track again, and I’ll see you in six months!”

If we cannot convey a positive message in some fashion, our patients will go away. They don’t need us to beat them up. I once worked with a hygienist whose patients labeled her the Wicked Witch of the West. So many people refused to see her because of her endless criticism. She was an excellent clinician, but in the end, the doctor had so many complaints that he could not fill her chair, and he had to let her go.

Bottom line, the folks are here, they are sitting in our patient chairs, and as I often tell them, “Today is the first day of the rest of your life.” Let’s celebrate that and inspire them to want to return to us! Onward we go. It is in our hearts’ core. RDH

EILEEN MORRISSEY, RDH, MS, is a practicing clinician, speaker, and writer. She is an adjunct dental hygiene faculty member at Burlington County College. Eileen offers CE forums to doctors, hygienists, and their teams. Reach her at [email protected] or 609-259-8008. Visit her website at www.eileenmorrissey. com.

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