A trip inside a patient's mind

May 27, 2005
A patient's homicidal actions soon after a botched dental appointment certainly makes one think about the human connection in dentistry.

by Kristine Hodsdon, RDH

Can we ever truly comprehend what thoughts are circulating in the minds of our patients? If we can, could we influence an inconceivable deed by a patient in the future just by providing a dental hygiene service?

Hygienists are all too familiar with dental phobias and patients who do not want to be in our dental chairs. Yet, when they leave our offices and return to their "normal" lives, what effect (or not) have we had on their non-dental lives?

My pondering of these "butterfly effect" - or, more simply, "cause and effect" questions- is a direct result of a patient's actions shortly after leaving my dental office.

The time was about 4 p.m. and my 3:45 p.m. patient was nowhere to be found. Since he was my last patient of that day, I began to shut down my hygiene room and was working on my end of the day duties. But who came sauntering in around 4:15 p.m. My patient. Let's call him Mike.

Flashback to about five days prior when Mike, a 21-year-old male, came in all prepared for a hygiene visit. He mistakenly forgot that his appointment was actually the day before, and he had failed. This appointment mess-up genuinely concerned him. Mike explained to us that his father was, "laying down the law," and he had been strongly encouraged to take on more responsibility for his life. Mike expressed at the original appointment debacle that he was afraid that his father would be upset with him. When she heard this, Doreen, our appointment coordinator, gave him the very first hygiene availability.

Now faced with another hygiene mix-up, Doreen and I explained to Mike that we again needed to reschedule his appointment because of the lateness in the day and his unfortunate tardiness. He again expressed concern for what his Dad would do when he returned from his business trip, and learned that Mike never actually had his teeth cleaned.

We assured Mike that if his Dad was that worried he could call the office and I would gladly share in the responsibility of having to re-schedule his appointment. I felt sorry for Mike and wanted to somehow help him with his perceived negative parental reaction.

Fifty-six hours after we again rescheduled Mike for his hygiene appointment, Mike committed the most heinous of crimes: He murdered his mother in their home.

I'm not that altruistic (or even the other end of the spectrum, egotistical) to completely believe that a clean, plaque-free mouth would have altered the unimaginable course of events. Yet, I do ask myself if the human connection, that often unappreciated component of a hygiene service, could have made a difference?

I know I have sometimes forgotten this important aspect of our role as oral health-care providers. The human touch and attention is what many of our patients so desperately crave. For many, it's the sole reason for never missing an appointment.

Even though I cannot take a trip inside my patients' minds to hear their thoughts and feelings, Mike and this family tragedy will remind me to step back more frequently from production numbers and schedules and ponder the "cause and effect" relationship and questions of dental hygiene.

By the way, Mike's Dad did call the office, a few days after this catastrophe. He wanted to know why Mike's teeth were never "cleaned."

Kristine Hodsdon, RDH, has gained her wings with 21 years in the industry, tackling everything from dental assisting, clinical hygiene and adjunct teaching to international speaking/writing, and success in sales. She is the Director of RDH eVillage, an online newsletter published by the PennWell Corporation. She currently speaks and consults on the future of dental hygiene, speaking skills, and the components of aesthetic hygiene. Kristine is a proud member of the NSA, ADHA, IFDH, IADR, and ACCD.