Yes, there is a right time for parrying with patients over health care issues. But, sometimes, the right thing to do is to offer a little human contact ... and, sometimes, the favor will be returned when you need it.
by Cappy C. Snider, RDH
I have been a hygienist for 15 years, and, for 15 years, I have been touched and enriched by the patients — the people — I have come in contact with during my career. Some of our most important work comes in the form of encouraging and supporting our patients. These very people we are first positioned to educate and brighten smiles for often become more than that over the course of time.
Admittedly, in the beginning of my career, I was busy getting the required elements of a dental hygiene visit accomplished in the allotted time. Small talk and trying to get acquainted with the patient was something that would have to come later. I was just trying to stay on a halfway decent schedule! With experience came clinical confidence, and only then did I actually realize there was a real, live human being attached to that set of teeth I had been working so diligently on. Only then did I venture to ask a few questions that could provide insight into their daily lives.
As hygienists, we work in close physical proximity to our patients. We are with them for a long and unbroken time during their recall appointments. Some patients desire a little human contact — a hand rested gently on their arm as they speak, a friendly pat on the shoulders as they leave, or just a smiling face to greet them as they arrive for their visit. I think these small gestures mean so much to our patients. We can build trust and put our patients at ease just by being approachable and showing a measure of warmth.
Some years into my career I realized one day that not only was I helping to repair and maintain my patient's oral health, I was often a source of comfort, a sounding board, or even a confidant for some of these special patients. A few particularly touching experiences stay with me to this day.
Sarah, Dorothy, and Susan
I had seen Sarah for several years for her oral hygiene visits, and each visit brought a sense of dread to my day. No matter how hard I tried to establish a rapport with her, I could never elicit more than short, sharp replies: "How have you been feeling?" "Fine!" "Have you been keeping busy?" "Not really!" This was the general course of any conversation. I thought perhaps the generation gap was just too large for a youngster like me to communicate with a seasoned woman like her.
Then came the visit that opened all of the doors. Somehow, the topic of sewing came up between us and I discovered that Sarah was an excellent seamstress with so much wisdom just waiting to be shared. Sewing was a skill I had always admired and wanted to know more about. From that day forward, she always had a ready smile for me, as well as some interesting information to share regarding our common interest. Now that we had become friends, she was also much more receptive to the suggestions I made concerning her dental care.
I now alter my priorities during the hygiene appointment when the occasion calls for it. I realize that oral health is not always what is paramount on my patient's mind. A life or family crisis may be overshadowing everything else for the patient that day.
An illustration of this was the day Dorothy lay in the patient chair and began to cry midway through the visit. I had no idea what I might have done to prompt these tears, as Dorothy was usually such a bright and sunny person. I stopped what I was doing and tried to comfort her. After a few minutes of talking, she shared with me that she recently had to commit her teenage daughter to a drug rehabilitation program after a difficult physical struggle. She was heartbroken.
Dorothy did not need to know that her teeth were free of pathogenic bacteria, or where she was missing with her toothbrush. We would address that at another visit. She just needed a sympathetic ear and words of comfort. I did the best I could to provide a little of both. We formed a special relationship over the many years I saw her as a patient, and as a friend.
Sometimes a patient can really affect us without even realizing it. I think we like to believe we are always there to encourage and teach our patients. On some occasions, though, we find that the tables have been turned. This was the case with a patient, Susan, whom I met just a couple of years ago.
Susan revealed to me that she was very embarrassed about the condition of her mouth in general. She was a young, pretty, single mother who had returned to college to pursue a degree in music therapy. She loved music and loved to sing. She wanted to use these gifts to help others. This step in her life was especially significant because she had overcome a drug addiction and had gotten her life on a very positive course. She was grateful for the friends and family that supported her new life.
Unfortunately, the drug use had taken its toll on her dental health. I was charged with helping to restore her gingival health and much time was spent on oral hygiene education, as well as a course of nonsurgical periodontal therapy. Several visits later, the gum tissue looked wonderful, and she had had many teeth restored with various crowns and bonded composite restorations. One of our final visits was the one that really affected me. Susan shared with me how she had been ashamed to sing in front of her classmates due to the condition of her mouth, and now she could now sing as enthusiastically as her heart had always wanted to. Her tears of joy were contagious as she thanked me for being a part of her transformation.
My experience with Susan showed me that I was indeed in the career I was meant to be in and she affirmed that what I did, day in and day out, patient after patient, tooth after tooth, really mattered. Granted, it mattered to some more than others, but my work was important and I could make a difference in my little world, in my little operatory.
Many days, dental hygiene seems very repetitive. I have found that what keeps it challenging and interesting are the people I am privileged to meet. When I changed employers more than a year ago, leaving behind many of these special patients was the most difficult part. I still miss them and they cross my mind often. I hope the best for each of them. I have learned, however, that there are wonderful, interesting, caring patients at my new office. It is a joy getting to know many of the patients on my schedule each day.
While focusing on the job at hand and providing the best care I possibly can is my highest priority, I try to take a few minutes to know the patient better. I have often gained valuable insight into customizing a patient's homecare routine by just listening to them or solving a homecare problem by the knowledge I gained in conversation.
Our unique position allows us to care for the whole person, not just their mouths. Sometimes this means making a note to get that calculus spicule from the distal of tooth number 15 at the next recall visit, knowing it will not cause a fatality in the next several months! Sometimes it means lending emotional support and encouragement to this particular patient on this particular day.
Developing great relationships with our patients certainly works in both directions. They feel cared for and value the service we provide for them. We feel valued for the time and effort we put into our work every day. We can then look forward to seeing these special patients on our schedule, and look forward to meeting even more of them as our careers proceed. I look at each meeting as a learning opportunity. I have learned about the many interesting careers my patients have, medical problems and their solutions, exciting life experiences, parenting advice, and even how to make a flaky pie crust! What diversity I have discovered in my patient's lives, and wonderful things I have learned by taking just a few moments to discover who is behind that mouth.
Cappy C. Snider, RDH, graduated from Tarrant County College in 1987. She has practiced continually for the past 15 years. Snider currently practices clinical dental hygiene with Dr. Brooke Porter of Azle Dental Care in Azle, Texas. She may be reached by email at email@example.com.