The lying hygienist

by Shirley Gutkowski

Kids don't like adults to lie to them. They grow up to be distrustful, and we all know that everyone needs to have a certain amount of trust in order to function in our daily lives. We have to trust that what comes out of the hose at the gas station is what we think it is, and not some watered-down concoction. We also have to trust the little computer that tells us how much gas is put into the ol' Tin Lizzy.

In general, we all trust our employers to pay us in a timely fashion, trust our spouses, our parents, and our educators. See, we really have to trust a lot in order to make it through the day. It's amazing how much we trust, considering how many adults lie to us, and how often they do it when we're children. I'm not talking about cultural lies either, like the stories of Grimm or the stories that orbit our major holidays. I'm talking about flat-out fibs to get kids to do what we want them to do.

How about the one about going to the doctor? "It won't hurt." By the time children are three they know darn well that story is a load of diaper filling. The stethoscope is cold, the otoscope is cold, and the shot ... well ... I won't go there. Adults tell kids that foods taste good when they don't. If strained peas mixed with strained squash were really so good, why doesn't Green Giant package them together? And dental personnel are no better. No wonder that once kids get into our chair they don't believe a thing we say.

We tell them that prophy paste tastes good, and that the gloves don't smell bad. We tell them we're going to tickle their teeth, and we use a hook to count them. Geez, it's worse than I thought! Imagine if you were three and some masked stranger (your parents warned you about strangers) came at you with a pointy hook to count your teeth. One thing that I learned from practicing dental hygiene over all these years is that kids are pretty darn smart. Most have a first-rate BS-o-meter.

Once the rapport is built and the child is maturing and growing up, we have a little easier time. What if you notice, or suspect, that the child is smoking cigarettes? Not many people understand that tobacco is the gateway drug1. It's a serious complication to a healthful life. In most cases, children who begin smoking do so with full knowledge of the certain dire consequences as told to them by the DARE program, teachers, doctors, parents, grandparents, and the rest of the people who are there to steer them in the right direction. Their reality is much different than the warnings. For one thing, they see themselves as invincible. For another, they know at least 10,000 people who smoke and none of them are suffering the consequences mapped out by the naysayers. Seeing is believing, after all, and they aren't seeing what's described to them.

Imagine now that the hygienist stumbles across this information when treating a 16-year-old child. She or he nearly always automatically goes into lecture No. 29 about how he's going to get lung cancer. Or, if the patient is using spit tobacco, how the patient will be harmed by oral cancer. Graphic dental hygienists talk about having surgery. Then the hygienist may notice that the child has a glazed look — the one most history teachers see. The connection is broken, so the oral health care provider steps it up another notch and tells about his or her relative that lost a lung or half his face to rapidly spreading cancer.

The smart child will engage the hygienist momentarily, and then totally blow off the whole conversation once the chair is upright. He knows the hygienist is full of it, just like every other adult in his or her life.

How different will this scene play out if the dental hygienist asked the patient how long they planned to smoke or dip?

While we're talking about the middle teenage group, what about the patients who present with tons of biofilm on their teeth? Most hygienists go right to cosmetics. "Sonny, your breath is going to smell bad if you don't brush your teeth," they say. "Who's going to want to kiss you?" they ask as if a light bulb is going to go off over the impressionable one's head. After disclosing the patient's teeth, they comment on their kissability with that much plaque on the teeth. They polish up the patient, ask them if their teeth feel better, get a positive response, and the oral health care provider again reigns triumphant in the education of a minor child. What they choose not to know is that the kid has their number. The teenager was likely in the middle of a fantastic make-out session just last night. To them the hygienist is a liar.

Not all people have the same perspective. People come from all different backgrounds. Some give no value to oral health. Uncle Joe, or Sam, or Jose, or Kim may look like a dental cripple to our educated eyes, but he seems to get along fine with his crumbling teeth to a 16-year-old. Great Grandmother loves her dentures. Oral health care providers who talk as if these people are suffering because they don't have the same oral health as an odontophile make it easy for the adolescent to view us as people who don't know what we're talking about or flat-out liars.

Read patients in the light they bring with them, not the light we use to see ourselves. As alike as people are in certain ways, they are totally different in others. Don't inadvertently turn yourself into a liar.

Shirley Gutkowski, RDH, BSDH, has been a practicing dental hygienist since 1986. She is a popular speaker and award-winning author. Gutkowski and Amy Nieves, RDH, are the co-authors of "The Purple Guide: Developing Your Dental Hygiene Career," a handbook for graduates from dental hygiene school. Gutkowski can be contacted at [email protected].