The pet peeves of RDHs: From cell phones to swallowing, dental patients can disrupt care

Jan. 16, 2017
Eileen Morrissey, RDH, examines habits of dental patients that are pet peeves for dental hygienists.

By Eileen Morrissey, RDH, MS

On a recent Internet subscriber list, a hygienist posted about one of the pet peeves she has with some of her patients. She invited other RDHs to do the same, and 11 pages of commentary followed. I thought it might be interesting to highlight several of these irritations, followed by positive solutions.

By far, the vexation most frequently mentioned was cell phone use by patients during dental hygiene treatment. Specifically, individuals with a cell phone in their hands are either attempting to accept a call or text while undergoing patient care.

In my office (as I suspect in many offices) there are signs posted that ask patients to kindly turn off their cell phones while in the treatment area. We experience virtually a 100% compliance rate with this policy. On several occasions, I have granted patients their requests to keep their phones on. Once it was a mother with an ill child who was waiting to hear from the school nurse. Another patient had submitted an offer on a house just before her appointment and wanted to be able to respond quickly if an additional offer needed to be made. Just last week, one of my senior patients had been playing telephone tag with his physician and desperately needed to make contact.

These people were so sincere and apologetic about their requests that I felt it was totally appropriate to let them have their phones on. On the other hand, I'm adamant that people who are so rude as to attempt talking or texting during dental hygiene procedures should be confronted the moment they try. Not only does this show a complete lack of consideration, it's dangerous!

It happened to me twice at a previous office. I stopped working, looked the patient directly in the eye, and said graciously and firmly, "You're not going to be able to do this while I am working." Both times the people apologized and put their cell phone aside. If you find yourself in this situation and are pressed further, you might respond with, "This is for your safety. When I'm using sharp instruments, I need stability that we won't have if your mouth and hands are moving." Note: Do not proceed further until the patient complies.

Another source of irritation that was mentioned was how to deal with patients who refuse to swallow their saliva during dental hygiene treatment. I'm not entirely sure we will be able to change these folks! We can make sure that we place the saliva ejector where it maximizes suctioning. We might also give patients control of the ejector. (Recognize that this might result in it being in your way, as well as frequent stops occurring to clear the mouth.) Note: One consistency I find is that annoyances like this tend to be more irritating when I am off or unbalanced myself. So we may have to go with the flow and ride with the salivary tide on this one. (Sorry, I couldn't resist.)

Beyond these two scenarios, there were complaints about people hacking, as well as those who stare at us throughout the entire treatment. Then there were complaints about patients who will not turn their mouths toward us when we ask them to, or ones who slowly close down as we are trying to work through a half-open mouth that is barely accessible. RDHs mentioned patients who smack their lips after treatment, or who groan and make strange noises during treatment. There are patients with tongues and lower lips that we must do battle with, and those who lick or suck our fingers when our hands are in their mouths.

I could go on and on, but I'm sure you get the idea. I had to laugh when I saw the posting from a clinician who said that her pet peeve is hygienists who complain!

On another note, my favorite is the new patient who pointed to her crown and told me to be careful because, "This is a crown." This does not irritate me. It makes me want to laugh. With a big smile I responded, "Thanks for letting me know!" I've also been known to add, "Are you aware that if ever your crown is removed during a cleaning, the hygienist has actually done you a favor? It's true! The crown cannot come off unless it is loose, and if it's loose, the seal is partially missing. This means you're at higher risk for getting decay underneath it. Better that it comes off here at the office rather than when you're out to dinner, right?"

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