by Anne Nugent Guignon, RDH, MPH
Every trip to the physician's office has some type of preliminary assessment that includes recording such vital signs as height, weight, blood pressure, and temperature. Most dental offices record similar data.
Dental professionals are trained to observe the tiniest details about our patients, observations that can be part of our total patient assessment. We can observe a patient's gait as he or she walks into the treatment room. We can take note of skin tone and color, voice pitch, pace of diction, and general demeanor. Whether these details are part of our conscious assessment, our impression of these details creates the framework for how we're going to interact with the person in our care.
Years ago members of the Amy RDH e–mail list coined the term chat and polish, a phrase now often shortened to C&P. Chat and polish is typically used as a negative term to describe the clinician who spends the day using fluffy conversation to fill dead air space during the hygiene appointment.
It's easy to appreciate the frustrations of hygienists who view seemingly mindless chatter as a complete waste of time or disservice to the patient. However, chatting with a patient, especially at the beginning of an appointment, can be a worthwhile use of appointment time. Valuable clues that help us take a patient's emotional temperature are often woven into these moments of social exchange. With practice, it becomes second nature for the hygienist to determine if adding some emotional warmth during a dental hygiene visit will produce a big payoff.
Deborah Hartley shared a story that epitomizes how chatter can be the best medicine. One of her patients, a high–level government employee, missed her hygiene appointment the day after 9/11. One week later, the woman arrived disheveled and obviously sleep deprived. The horrors of the previous seven days had taken their toll on her composure.
Sensing that her patient would be oblivious to serious conversation, Deborah accommodated her patient's request to “turn on the mindless chatter,” so she launched into a stream of light conversation that filled the entire appointment. At the end of the session, the emotionally drained patient thanked Deborah for providing the first relaxing hour in a week, which proved that idle chatter has its place.
Other patients operate from a Joe Friday “just the facts, ma'am” mode. They want bare bones information, preferably delivered in bullet point format. They'll tell you when they want more information and will cut you off when they've had enough. Mindless chatter and humor drive them up a wall.
Some people need proof. They want to know the science behind every recommendation, as well as the entire range of options available for a situation. Statements such as “If it were my mouth,” or “If you were my mother (or sister or daughter)” before a recommendation is the reassurance they need to know they're making a sound decision.
Through the years it's been a wonderful opportunity and great challenge to treat tense, anxious patients. When I use a dose of patience and an ounce of tact, it usually doesn't take much time for me to discover what's causing a problem. Sometimes it's something as simple as the taste of the prophy paste. Other times it's a genuine fear of pain, which can be resolved by an effective desensitizer or well–placed anesthesia. As strange as it may seem, some nervous patients find our chatter a soothing distraction from the real task at hand. Focusing on what we're saying is the perfect way for some people to detach from the clinical experience.
Then there are the patients who start their appointment with the latest picture of their grandchildren, dog, or vacation. Others come bearing gifts of cookies, sandwiches, or bags of homegrown tomatoes or cucumbers. In their minds, we're like family. With the big push on patients finding a dental “home,” it's nice that they consider us a special part of their lives.
Some may consider nondental chats a waste of time, but used in the right place at the right time, mindless chatter can create a comfort zone that can keep patients coming back for our care for years to come.
About the Author
Anne Nugent Guignon, RDH, MPH, is the senior consulting editor for RDH magazine. She is an international speaker who has published numerous articles and authored several textbook chapters, as well as present seminars. She is a recipient of the 2004 Mentor of the Year Award, and has practiced dental hygiene in Houston since 1971.