By Valerie Gantner, RDH
Like many dental hygienists, I love scaling and the sense of accomplishment that comes from removing calculus and stain. When I see a periodontal patient, my hand twitches as I resist the urge to break out my ultrasonic scaler until I’ve completed my assessment. It’s not simply about the task at hand. I have found there’s no better feeling than knowing you’ve helped patients improve their oral health.
It would be nice to say that I’ve had moments like these with all of my patients, but unfortunately I’ve also experienced epic fails. It’s hard not to take it personally when a patient continues to have poor oral hygiene or simply doesn’t take my advice. But what troubles me the most is the patients who have “ghosted” me. If you’re not familiar with the term, in the romantic sense it means the ending of a relationship without explanation and the ceasing of all communication. In the dental setting it can mean a no-show along with failure to reschedule or even acknowledge any communication from the office.
I am deeply invested in my relationships with patients, so when this ghosting occurs I always assume the reasons are beyond my control. Perhaps they moved and forgot to let us know, or they lost their job and no longer have dental insurance. Clearly it couldn’t be that they didn’t want to hear me lecture them about flossing. Right?
We never want to think it’s us. Some years ago, when I was starting out in a new practice, I saw a male patient who had ghosted his previous hygienist. Two years prior he had received scaling and root planing for early periodontal disease and never returned to that office. Unfortunately, because this patient had not had any treatment in the two-year time span and had poor oral hygiene, my dental hygiene treatment plan included re-treatment with scaling and root planing. When the treatment plan was accepted, I felt confident that my relationship with him would be different and that he would return for periodontal maintenance. To my surprise, he cancelled his first maintenance visit three months later. I called him, sent a letter, and called him again. I was sure we’d had a good thing together. He had promised me he would come back. What happened? Where did he go? It bothered me.
Two years went by, and one day, there he was on my schedule. Like before, due to lack of professional and at-home care, his periodontal condition was deteriorating, so we did the same drill all over again. I reiterated the importance of periodontal maintenance visits and home care. And he did it again! He disappeared, poof, into thin air. I felt like I was in the movie “Groundhog Day!” I thought, “Surely this time there have to be some family problems, health issues, or a financial catastrophe for him to just leave me.”
Another two years passed, and there he was on my schedule again! Admittedly, this time I wasn’t exactly happy to see him. In fact, I was determined I was finally going to get an explanation about his behavior. When I asked, he told me that every time he went to the dentist’s office, the news was negative. He required periodontal therapy, again, and he needed to improve his home care. He emphatically told me he didn’t want to floss and didn’t want a lecture. End of story.
Wow. Lecture. Was that how he saw my efforts? I was mortified. All along I was sure his ghosting was about him. Of course, in many ways it was. But I also had to acknowledge that I had played a role in his situation. As hard as it was, I told him this was going to stop, and it would stop with me. If he wasn’t going to floss, we would come up with something else. Together, we would stop this cycle.
Not recommending string floss, felt, well, like I was providing him with a “better than nothing” alternative. But I knew I had to come up with something that he could do at home instead of flossing. Otherwise, I was going to lose him again. The first product I thought of was the Water Flosser by Waterpik. I’d recently attended a continuing education course where the speaker spoke highly of water flossing, especially for periodontal and implant patients. With fingers crossed I recommended it, and I anxiously hoped and waited for his return in three months.
Three months and one day later, this man kept his periodontal maintenance appointment for the first time ever. He even walked in early for his appointment. I was surprised to say the least. When he got in the chair and I started my periodontal assessment, we were both nervous. What a thrill to tell him the probing readings were normal and there was no bleeding. From that day forward, he rarely missed a periodontal maintenance visit with me and became a forever fan of water flossing.
Since that day I’ve changed my mindset about my recommendations for my patients. Instead of routinely recommending flossing, I try to offer other options. Flossing is not for everyone. I’ve found the Water Flosser to be easy to use, and it provides great results, especially for my periodontal, implant, or orthodontic patients. I’ve also observed that when I really listen to my patients and give them options outside of string flossing, they are less likely to ghost me. RDH
Valerie Gantner, RDH, has been a clinical dental hygienist for 17 years. She enjoys balancing her time between private practice in Glassboro, New Jersey, and being an independent professional educator on behalf of Waterpik. Valerie can be reached at [email protected].