5 Patients That Drive Dental Hygienists Crazy

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All dental hygienists can appreciate that sometimes there are those patients who can make clinical life a little more difficult. The following is a list of five patient types that can test our patience and some strategies to better manage the challenges they present.

The Self-Proclaimed Expert

We all know them, they have proudly consulted social media to brush up on the most up to date medical knowledge before their dental appointment. They arrive ready to use their newfound knowledge to question their unsuspecting dental hygienist every step of the way regarding every recommendation for treatment. They pepper clinicians with a mind-numbing array of queries before we can so much as take their blood pressure, and forget about taking radiographs! They request nothing short of a thesis presentation explaining the pros versus cons before granting permission to take a bitewing. It can be exhausting for even the most energetic dental hygienist to treat a patient like this.

While we, as dental hygienists, always support patients becoming more involved in their dental health, these Self-Proclaimed Experts take it to an extreme that can become detrimental to their health.

Your best course of action is to stand firm to what you know from your years of education and experience, and use that knowledge to educate and treat these patients to the best of your ability. Patients are inundated with information these days, and we must be a beacon of valid information to cut through the noise. Hopefully, they will come to recognize we have their best interests in my mind and are a far better resource for dental health information than the internet and social media.

The Late Arrival

It is twenty minutes past their appointment time, and you have already assumed they aren’t coming when in strolls your next patient. Nothing is more aggravating for a hygienist than this scenario, especially if it is a chronic problem. Unfortunately, this is something some patients force us to deal with all the time.

Patient tardiness tends to have a domino effect on the whole practice. It not only causes stress on the practitioner who is trying to make up for the reduced time availability, but it also inconveniences other patients, leading to decreased patient satisfaction.

The best way to combat this problem is for the dental practice to adopt a patient tardiness policy and stick to it. Usually, the policy would be that after a 15-20 minute time window for late arrivals, the patient can no longer be seen and would need to reschedule. This tactic generally leads to patients respecting their appointment times and reduces the number of tardy patients.1

The Anti-Recliner

It’s the last patient of the day, you’re ready to get started with treatment, and you press the button to lay the patients chair back. Suddenly they are gripping the armrests and voicing their protests while giving you the stink eye like you just tried to push them off a cliff. Sound familiar? We’ve all been there.

As we all know the dental hygiene field is afflicted with so many job-related musculoskeletal problems that it is a wonder we can get out of bed in the morning. Personally, I blame it all on patients who refuse to recline. Okay, so maybe it’s not all their fault, but they do hold a large portion of the blame.

For dental hygienists to practice as ergonomically as possible, our patients need to be lying in a supine position. When patients refuse to do so, it severely hinders our ability to work in a comfortable position, as well as our ability to give our patients the most thorough and safe care possible.

There are a couple of tactics that dental hygienists can use to tackle this situation. First, communicating to the patient that this position is necessary for their health and wellbeing, is sometimes all it takes. If the patient understands that you are doing this for hours on end, and they only need to tolerate this position for the length of their appointment, then many are happy to comply. Sometimes it is just the transition into the supine position that they dislike, and limiting the number of times you raise and lower the chair solves the problem.

There is a little trick you can use if you know an Anti-Recliner is coming in. Start the chair off in a slightly more reclined position when they are initially seated so they will be starting off a little further back than usual. When you go to lay them down, it won’t feel like they are going back as far. It’s just a little psychological trick, but it helps.

The Bundle of Nerves

No matter how much we try to put them at ease, there are always those patients that get in the dental chair and immediately break out in a sweat. They cringe and tense up as we try to retract their cheeks and jump every time the scaler even touches their gingiva. Their tension can translate to us and cause anxiety on both sides.

Dental anxiety is a very real problem for many patients, and it can hinder treatment. According to a study in The Journal of Dental Hygiene, 19% of patients have a moderate to high dental treatment anxiety level.2 That’s almost 1 in every five patients!

The most important thing to remember when treating patients with dental anxiety is to stay calm yourself. This is easier said than done, but by projecting a serene presence, you will, in turn, ease your patient’s nerves and maintain control of the appointment. Don’t hesitate to ask them what is giving them anxiety or is making them fearful. Sometimes knowing what their trigger is, can help us avoid the trigger. If all else fails, some patients can benefit from anti-anxiety medications prior to appointments or offer nitrous oxide. Stay calm and scale on should be your motto with these patients!

The Chatty Challenge

This type of patient is often our favorite and most challenging all at once. Our chatty patients are the ones that bring us homemade cookies, ask about our children and vacations, and are always pleasant to treat. Unfortunately, as much as we enjoy them, these patients can also eat into appointment times with conversation, and before we know it, we’re running behind schedule.

Managing chatty patients is something that comes with experience. Over time you can learn to prioritize clinical treatment and use the beginning and end of appointments for social interactions. Try to minimize conversation until you’re waiting for the doctor, which can be an ideal time for conversation as it distracts the patient while they are waiting, and helps build your clinician/patient relationship.

These five patient types represent only a few of the difficult personalities that can present challenges for us in the operatory. As always, we as dental hygienists, are resourceful and will strive to find ways to manage and overcome them.

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  1. Williams, Kayode A et al. “Patient punctuality and clinic performance: observations from an academic-based private practice pain centre: a prospective quality improvement study” BMJ open 4,5 e004679. 15 May. 2014, doi:10.1136/bmjopen-2013-004679
  2. White, Angela. “The Prevalence of Dental Anxiety in Dental Practice Settings .” Journal of Dental Hygiene, American Dental Hygiene Association, Feb. 2017, jdh.adha.org/content/91/1/30.