Things Are Looking Up

Aug. 1, 1999
Are patients grumbling about the ho-hum view? Let them gaze upwards at videos, mobiles, posters, or other eye-catching focal points. Sitting in the chair can be anything but boring. It might (gasp!) even be fun.

Are patients grumbling about the ho-hum view? Let them gaze upwards at videos, mobiles, posters, or other eye-catching focal points. Sitting in the chair can be anything but boring. It might (gasp!) even be fun.

Joanne Iannone Sheehan, RDH

The phone rang. It was my sister Helen calling from her home in Kauai, Hawaii. "I just got back from the dentist," she moaned, "where I spent the most boring 45 minutes of my life."

"Don`t you like your dentist?" I asked.

"Sure I do. He`s gentle, professional, and even kind of cute. But I can`t stare at him for 45 minutes while I`m flat on my back. How rude! Plus, he might get nervous and slip with the drill or that other sharp thingy he was using. So I had to stare at the ceiling the whole time. I think I know every crack, bump, and fly speck! Talk about mind-numbing torture! You people need to do something with your ceilings!"

Helen was never one to settle for the mundane just because everyone else did. But, thinking about her argument, I had to admit she had a point. Our patients stay in a prone position for most of their 45- to 60-minute appointments. Even when artwork is displayed on the walls, it`s out of view much of the time. How many patients have succumbed to the expressionless void of semi-glossy latex, only because no one has ever said, "Hey! We`re imaginative, creative, thinking individuals down here! While you`re keeping busy in our mouths, what has been done to occupy our minds?"

Any woman will tell you that gynecologists corner the market on ceilings. They`re aware of the positioning of their patients, and have provided something other than the procedure to focus on. It makes for a more relaxed patient and less stressful visit. Maybe that`s what some of our patients mean when they say they`d rather have a baby than get their teeth cleaned! Maybe not.

Dental professionals are every bit as imaginative as their medical counterparts, possibly more so. Let`s start with what the gynecologists have used for years and go from there. Some offices attach mobiles to the ceiling to divert one`s attention. One patient I interviewed said her OB-GYN brought back mobiles from all the exotic places he had visited. There was a regular museum suspended over the examining table. Let`s hope they were securely fastened.

Other offices have photos of well-known celebrities of the male gender to relax the patient. (That sometimes has the opposite effect.) Colored stickers in the shape of flowers are used as a focal point. And once I saw a poster with a hissing black cat and the caption, "I have PMS and a handgun. Any questions?"

I think we can do better than that. In questioning my patients about their view from the dental chair, I found that they had never thought about options before, but now were delighted to give suggestions. I filed their ideas into four categories:

* Humorous

* Educational

* Entertaining

* Shock Effect


If your doctor likes to laugh, he or she might go for something in the humorous category. You could blow up a photo of a consenting patient with a piece of floss hanging from between each tooth and the caption, "Did you keep your promise to floss daily?"

Or you might have the confession of the repentant semi-flossers, intertwined with shred-resistant unwaxed, lamenting, "Not as much as I should..."

You might paraphrase an old saying from World War II: Floss `em if you got `em!

If you`re really brave, YOU might pose for a photo depicting one of your patients sitting chairside, a smile beaming satisfaction (or is it revenge?) with instruments at the ready to scale YOUR teeth.


If your office is more sedate and geared toward patient education, you might try posting some dental hygiene tips on the ceiling, such as:

- Change your toothbrush every two to three months and/or after an illness. No hard brushes!

- Display different types of floss and a diagram demonstrating which fingers to use. Include floss aids or interproximal brushes.

- List products your office carries which may be of interest; i.e., bleaching kits, night guards, chlorhexidine gluconate chips for some perio pockets, fluorides, solutions for halitosis, etc.

- Actual photos of a patient`s teeth before and after such procedures as scaling and root planing, orthodontic treatment, perio surgery, restorations, crown and bridge, and/or bleaching.

Intraoral cameras tell it all, sometimes more than they want to see. But what an educational tool! Now picture a screen mounted ceiling-high on the wall. Here, the patient can get an eyeful of a problem area that is consistently missed with the brush or floss. One maximized picture of that is worth five minutes of exhortation. People are busy and most don`t take the time to look inside their mouths to evaluate their home care. This could be their big chance. With their "sins of omission" now showing on a ceiling near you, the hygienist`s words are reinforced in living color!


In asking my patients for ideas on "doing something with the ceiling," I got a variety of responses. It was interesting to see the rationale behind each patient`s suggestion.

One female patient came for her recall visit with so many angel pins on her blouse, collar, and adorning her ears that I had to ask if she expected a life-threatening experience in my chair. No, this was normal for her. And when asked what she would like to view during her appointment, she said she would like to get caught up in the clouds. She wanted to lose herself in the heavens and be at peace. I could get into that.

Another patient, of the male persuasion this time, came in dressed for success. He could have been a model for expensive Italian suits and had that air of confidence. He only took two seconds to respond to my question. He wanted to see "big green bills" on the ceiling. Unfortunately, that might make some financially challenged patients a little nervous.

A child I interviewed in the orthodontal office of Dr. James Lupi in Stafford, Va., said she wanted a nature scene with lots of detail in it, something she could look at for 30 minutes and still discover new things in it. She had a point about detail. How about a kind of "Where`s Waldo?" mural with your doctor`s face hidden in a sea of other faces (photos of patients taken in the office). If you get a good response from the kids, you could move "Dr. Waldo" periodically so they have to search for him each time they come. Kids love a challenge. The prizes for finding the doctor could be a friendship bracelet, stickers, pencils, etc., to go along with their new toothbrush.

The periodontal office of Dr. Richard Tami in Woodbridge, Va., has an alternative to boredom for the adult patient. In this office, patients have their choice of viewing operettas, the doctor`s home movies of whitewater rafting escapades and various other entertaining videos. The monitor is not on the ceiling, but over their heads, mounted on a folding swing arm attached to the wall. The possibilities are unlimited when using videos. The hard part is getting the patient out of the chair when he or she is caught up in what is being shown. Try to keep the films on the short side.

One way you can control the length of the video and educate your patient while you`re busy scaling is to make a video yourself. In it you can touch on all the aspects mentioned in the educational category and more. Actually demonstrate the correct fingers for flossing, the 45-degree angle for brushing, and share some facts about products for sensitive teeth, nutrition, gingivitis, and where periodontal disease usually starts (between the teeth). The topics are endless. You could make several tapes, one for each subject. When a patient comes in complaining of recently bleeding gums, give him a short introduction to Gingivitis 101, then pop in the tape you made on the causes, cure, and frequent consequences of untreated gingivitis. The patient can be educated and not have time taken away from his or her scaling. At the end of the tape, you can answer any questions that may have been raised. It`s efficient, effective, creative, and makes the most of the patient?s appointment time. Plus having a familiar face on the screen makes it that much more personable. And, who knows, you may find a new career in hygiene movies! (They?ve already made a movie about dentists. Remember Dustin Hoffman? OIs it safe?O)

Some offices have nothing but fluorescent lights over their chairs. One of my patients suggested stained glass over the light. I think that was my Oangel patient.O


To paraphrase a shopper?s quote, OI?ll know what I don?t want when I see it.O Because a picture is worth more words than the schedule allows, consider these attention-grabbing u blow-ups for your silent ceiling:

Picture this:

* A middle-aged married couple, holding hands and smiling ... totally edentulous!

* An attractive woman or man with perfect hair, complexion, clothes, and body...but the smile reveals rampant decay!

* A split screen of blow-ups of the amount of gram negative bacteria in a mouth before and after scaling and root planing.

While the shock effect is not for everybody and may offend some, it?s guaranteed to leave an indelible picture of the consequences of neglect on their minds. Strong images like these can be a silent, but effective, poke in the ribs of a lazy flosser or unenthused brusher. The basic message is, OIgnore your teeth and they?ll go away.O

Every office has a different Oatmosphere,O made up of the personalities of the dental staff and the patients who are treated there. While teaching the patient is one of our main goals, how you do it is up to you. For those precious minutes when your patient is in the chair, you have control of his horizontal and vertical brain waves. Try to make the most of what might otherwise be a boring, routine visit. Find a method that best fits your office and stimulate the brains of your patients in a new and creative way. Remember, the ceiling?s the limit!

Joanne Iannone Sheehan, RDH, graduated from the State University of New York at Farmingdale in 1974 and has practiced in New York, Pennsylvania, Virginia, Maryland, and Alabama. She has taught in North Carolina and worked for the Army as a dental hygienist in Germany for three years.