Compassion Leads to Compliance

July 10, 2015
Patient compliance, or lack thereof, can be one of the most frustrating things to deal with as a hygienist.

BY Kara Vavrosky, RDH

Patient compliance, or lack thereof, can be one of the most frustrating things to deal with as a hygienist. When a patient hasn't had treatment in years and then finally decides to make an appointment, it's a great time for a new start. We all know prevention is much better than restoration, and now we finally have the opportunity to set them on the right path. During the appointment we treat, educate, and make recommendations for future treatments and proper home care.

The patient seems to be in agreement, and we feel good about ourselves because we think we finally got through to them. Then they leave, and we never see them again. What happened? Why weren't we able to get through to them like we thought?

It's important to understand why patients avoid dental offices to begin with. While there are a variety of reasons, from my experience, fear, embarrassment, or a previously bad experience are at the top of the list, not to mention a lack of education on the connection between the mouth and overall health. Regardless of the reason, the longer patients avoid coming in, the less likely they are to do so. This is why it's so important to make the most of our time once they are finally in our chair.

I've had countless patients say to me, "I know I should have come in sooner." While it can be easy to silently judge them, I simply respond by saying, "You are here now, and that's all that matters. You have taken the first step of taking your health into your own hands, and you should be proud of that. Together we will get you where you need to go."

I let the patient know I'm not there to judge or embarrass them but to educate and help. I also don't lecture. I suggest. When the patient realizes your compassion, their anxiety goes down and they become much more receptive to what you have to say.

Once you have started to build that initial rapport with the patient, it's important to educate in a way that fosters understanding. As hygienists, we live in the mouth. It's very easy to forget that most people don't have the scientific knowledge as to why proper oral health is so important. It's like second nature to us, and while it's obvious to us, it isn't obvious to most. Keep this in mind when educating your patients.

Put yourself in their shoes, and think about what it was like before you began your schooling and education. Don't just tell a patient something; expand and explain why it's important. People are much more likely to remember something when they have an understanding of the "why" and not just the "what" or "how."

A great way to help patients understand importance is to use metaphors. Let's take flossing as an example. Most patients know they need to floss regularly, yet they don't. Instead of merely telling a patient, "You need to floss regularly," give a metaphor as to why it's important. I would have understood the importance of flossing much better as a child if my hygienist had said, "It's important to floss every day because there's bacteria in your mouth that can't be reached by a toothbrush. When you don't floss, the bacteria sits there and poops acid in your mouth." Putting this visual into a patient's head helps them understand the importance of flossing clearly.

While all the compassion and education in the world can help a patient understand the importance of why they need to do something, it is all for naught if they don't follow up. This is where we need to make it as easy as possible for the patient. When the appointment is coming to an end and you have recommended follow-up treatment, don't just send them on their way. Walk them up to the front desk, explain to your scheduler what follow-up treatment is needed, and get the patient scheduled right then and there. The patient will appreciate this personal touch because it takes the pressure off of them to explain what is needed. As a bonus, your doctor will appreciate your effort in keeping patients coming back.

Now the reality is that not all patients will be compliant, no matter what we say or do. This can be frustrating because we all want the best for our patients. However, knowing in our hearts that we did the best we could do should help provide peace of mind. While we can't get through to everybody, by practicing compassion and providing an education of understanding, you will see patient compliance improve. I encourage you to never stop trying. See the results for yourself! RDH

Kara Vavrosky, RDH, runs the popular Facebook page, Dental Hygiene with Kara RDH, and is also the founder of, a question and answer platform for dental hygienists. Kara serves on the Clinical Advisory Board of GoodMouth, a toothbrush subscription service, and the Advisory Board of Support Clean Dentistry, an initiative to raise awareness of cleanliness in the dental office. Kara currently works for a one-doctor, family-oriented practice in Portland, Oregon.