From Annoyance to Opportunity

Nov. 1, 2007
Just one more step” sounds more like an admonishment than encouragement. Hating that phrase has become a part-time job for me, consuming nearly four hours a week.

by Lory Laughter, RDH, BS

Just one more step” sounds more like an admonishment than encouragement. Hating that phrase has become a part-time job for me, consuming nearly four hours a week. The Torture Queen, more commonly known as physical therapist, makes a face every time I utter her pet name. You’d think I’d be more empathetic and refrain from name-calling after the wonderful pet names we dental hygienists have been called often enough throughout our career - prima donna, Dracula, and cleaning lady, to name a few. Some hygienists live for the day when they hear “My gums didn’t bleed until you poked me” and can retort “They would if you ever touched them with a toothbrush.”

Most patients are kind and considerate people, yet unaware that their comments are not new or funny anymore. Today is not the first day any of us have heard, “I’d rather have a baby than have my teeth cleaned.” We try to deliver cute and original comebacks to the age-old complaint, but the humor seems less appreciated when heard by the patient’s ears.

Years ago, a female patient was not even inside my operatory door when she wrinkled her nose and said, “It’s more enjoyable to see a gynecologist than come here.” To show my empathetic side, I offered to have stirrups installed on the chair for her subsequent visits. She didn’t laugh, but she did ask for me to be fired. Fortunately, my employer understood the humor.

Parents who try to prime their young children for dental visits all too often tell the youngster that the procedure won’t hurt. As professionals, we know even saying the word “hurt” brings negative images to the child’s mind. Worse yet is the parent who blurts out, “Hold still because the dentist doesn’t want to hurt you,” or “Don’t cry; they don’t mean to hurt you.” In my experience these comments are more than annoying. Such verbiage can be damaging to building trust with the young patient.

While attending RDH’s Under One Roof Conference, the conversation turned to things patients say that hygienists have heard enough of. This topic carried over into e-mail threads where the statements revealed are humorous and frustrating. The overall winner of things we don’t need to hear again is “That tooth is a crown (or bridge).” Usually the patient can be put at ease with the assurance that our education taught us to recognize such things. Occasionally, we meet the apprehensive soul who insists on reminding us not to pull it off. Informing this patient of the strength of cement does no good; he or she will still assume the hygienist is too rough and only removed the crown from the decayed molar to bring in extra bucks for the dentist.

We all cringe when the client with plaque covering every oral surface tells us to skip the “lecture.” I must point out that I never lecture, only inform, educate, disclose, and nag. Time watchers are also a challenge. This overly important patient wants out as soon as possible due to a very busy schedule. One approach suggested was to tell the person we only have to remove what he or she leaves behind. My favorite response came from a hygienist who pretended to be offended and hurt, telling the patient, “We set up this date six months ago. I feel crushed that you would schedule another meeting during our together time.” Humor sometimes works, if the other person gets it.

Comments from patients that make us wince also brought about some statements that make us smile or even laugh out loud. Diane had just finished a periodontal probing when she was asked, “Well, how many leaks do I have this time?” Tammy in Illinois shared a story about dropping a mouth mirror on the floor. The patient leaned over and retrieved the mirror, handing it back to Tammy. When Tammy set the mirror aside and sought out a sterile replacement, the patient stated his main concern, “You aren’t going to charge me for a new one, are you?”

There should be a show titled, “Patients say the darndest things.” The show’s premiere would include the father who upon being told his 8-year-old needed some fillings replied, “Just pull the tooth. I don’t want those fillings jingle jangling around in her mouth.” Another guest on the show would be Christel Autuori’s funny man who often shared his belief that if Christel would just do a better job, he wouldn’t need his teeth cleaned more than once a year. No opening night would be complete without a lineup of the hundreds who enjoy their twice yearly flossing. These individuals do not care how long it takes to ultrasonic, scale, and remove biofilm from their mouth - just don’t forget to floss.

Several colleagues brought up an amusing fact about our society. If we bring up bulimia, anorexia, or even possible meth use, patients are often offended at our intrusion into their private lives. Yet, point out a scratch or burn on the palate and many of these same folks will tell you about sexual practices that might have produced the lesion. I once saw a patient with an unusual colored stain on the lingual of all his maxillary teeth. When I questioned him about his consumption of coffee, tea, and tobacco, he told me such activities were a matter of personal choice and he did not have to give an answer. About five minutes later he stopped me and asked, “Does marijuana stain?” Marijuana - safe topic. Coffee - off limits!

In all fairness to the general public, most comments and questions are well-intentioned. The patient who constantly reminds us about the crown at least knows what is in his or her mouth. The opportunity can be turned from annoyance to patient education by using the statement as a lead-in to caring for restored teeth. The word “hurt” can be eliminated from a child’s dental visit when anxious parents are given suggested phrases in advance. And which of us can help but smile at the concerned citizen who refuses radiographs because of radiation, but smokes two packs a day.

About the Author

Lory Laughter, RDH, BS, practices in Napa and Sonoma, Calif., in both general and periodontal offices. She is a partner of Dental IQ, a team committed to arranging quality continuing-education opportunities for Northern California. Through her involvement with Dental Hygienists Against Heart Disease and other organizations, she hopes to bring a total health concept to the dental practice. You may contact Lory at [email protected].