Mental Health Spotlight: Grief Can Make Holiday Dental Appointments Not So Jolly and Bright

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For most of us, the holidays are a time of joy, family, remembrance, feasting, and celebration. We come together with family and friends with the intent of fostering togetherness and rejuvenation before entering a new year. However, for many, as the holidays approach, a deep dread begins as it is a time of grief and loneliness.

People who have lost a spouse, parent, child, or other loved one may take the most brutal hit of grief around the holidays. A time for celebration has become a time of sorrow, and the loved one is missed beyond measure.

Grief is defined as sorrow or anguish that is experienced after loss, usually the loss of a loved one. It can include physical, emotional, and psychological stress, such as confusion, yearning, separation anxiety, and sometimes suicidal thoughts.1

The holidays tend to give rise to feelings of grief because the beloved’s absence may seem amplified, especially if it is the first holiday since their passing. The American Psychological Association recommends preparing around the loss to lessen anxiety. This may look like changing a tradition that is too hard to face, creating new traditions or new places to celebrate, and including the person’s memory in the celebration.2

The first step is acknowledging that the holidays will be different and discussing what would lighten the load.2

Dental Care Amidst Grief

As dental professionals, it is essential to consider this when interacting with patients around this time of year. Dental hygienists are pros at relationship-building. We almost always know when something personal is happening with our long-time patients.

In some cases, when patients are not as familiar to us, we may be uninformed of their loss and not be aware that they are struggling. When we know our patient has lost a spouse or another loved one, we may find ourselves in an uncomfortable position as to what to say, how to say it, and if we should even say anything at all.

People say they avoid bringing up a loss because they do not want to remind them or make the person sad. Others have told me they feel uncomfortable bringing it up because they do not know what to say. The truth is they have not forgotten their loved one has died, and they are already sad. They appreciate that someone remembers. Granted, knowing what to say to the one grieving is complicated. Being present and listening to their story helps them to heal.

Conversations About Grief

Pam Ridling, a registered nurse and seasoned leader of a nationwide grief group called GriefShare, works with individuals and families who have endured a significant loss and are ready to face and process their grief. She walks them through their story in a group setting where they can experience others going through a similar situation. She holds sacred space for their pain and offers coping mechanisms to help them through the darkest parts.

As a survivor of many losses, including her mother at the age of nine, a husband, and a child, Ridling is no stranger to the cycles of grief, especially around the holidays. She says this makes GriefShare leadership a perfect fit for her and calls it her life’s work, her purpose, and her calling. Ridling has experienced grief from so many angles that she feels confident in providing a circle for seekers of relief to lay down their sorrow.

I asked Ridling if she would offer me some advice on sparking a conversation with dental patients, especially around the holidays. I asked her about the belief that bringing it up would leave my patient in a puddle of unwanted remembrance.

Ridling said that it depends on the specific situation, and it is important to establish trust and rapport with the person before jumping right into any serious conversations or questions. She stated that, for the most part, survivors welcome conversations about their deceased loved one. The process of talking about them helps relieve bottled-up thoughts and pain.

“Those grieving the loss of a loved one say that soon after the death, others return to their daily routine, visit less frequently, and stop talking about the deceased loved one. No one says the loved one’s name anymore.” Ridling said during an interview. Saying the person’s name and talking about a memory lets them live on. Acting as if the loss does not exist can fuel the grief fire, keeping it buried to kindle.3

Ridling says to ask gentle questions while showing empathy and respect to the deceased. Perhaps something like, “I can imagine the holidays will be different for you this year. How will you remember (fill in name)?”

She said, “Give the patient your undivided attention, make eye contact, and resist all temptation to tell your own story about loss. Give them the space to say whatever they need and let them know you hear them.” Sometimes, the patient needs to feel heard and seen on their grief-healing journey. It helps them feel less alone, and the vulnerability of telling their story may give them strength.3

Sharing Favorite Memories During the Holidays

Jennifer Johnson, the founder of a nonprofit called Brave Like Ellie, provides gift boxes to families affected by childhood cancer. Jennifer is the survivor of one of the most complex types of grief as she lost her three-year-old daughter, Ellie, after a 14-month battle with a rare form of leukemia. Johnson’s grief catapulted her into doing something to help others who are in a similar situation.

Johnson realizes that people are often afraid to bring up Ellie because they are mostly unsure of what to say. Johnson says to avoid saying things like, “Well, they are in a better place,” or “At least they are no longer suffering.”4

She said, “I believe in God and that she is healed, and I also wish that she was still here on this earth with me. I know people mean well, but such statements leave the grieving feeling unheard.”4

Instead, Johnson wants people to ask about Ellie or share their favorite memories, especially around the holidays. She knows that Brave Like Ellie keeps her baby girl’s spirit alive and always welcomes questions about how the project honors her.

Johnson said, “I don’t fault people for it. I know it is uncomfortable to talk about. I wish this were a more open conversation in our society, and we weren’t afraid to say the names of the people that have gone before us.” She says that when Ellie’s name is said, it honors the joy she brought to the family and lets that live on. Johnson says the holidays can be one of the most challenging times of the year because they so badly wish to celebrate with Ellie.4

Lighting Up the Sorrow

Another nonprofit, the Katie Palmer Project, provides Christmas lights for families that have suffered a loss during the year. Katie Palmer and her husband, John, were hit by a truck while on a walk one April morning. John sustained major injuries while Katie did not survive. The tragedy became highly publicized, and negativity and ongoing news stories seemed to be keeping John and his two children from peacefully grieving the loss.

Founder, firefighter, and investigator Dustin Bortzfield came up with the idea after the loss of a high school buddy’s wife. He saw the negativity swirling around the loss, and he wanted to do something to give the Palmer family something to look forward to, continuing to shine Katie’s bright light.

The Katie Palmer Project surprises 10 to 15 families each year with the gift of Christmas lights. Firefighters donate their time and show up at the families’ homes to install the lights. Bortzfield states that the most profound thing about this project is how something as simple as lights can honor the deceased and have such an impact on the family.

As someone who has witnessed a lot of loss as a firefighter and as the founder and president of this project, he said, “When it comes to helping people through grief during the holidays, the best thing I have found is to just be with them. Ask about their loved one and then listen. Really listen. Let the world stop around you and genuinely listen.”5

Holiday Grief and Depression

As we enter into the holiday season, here are some tips for addressing grief and potential depression and anxiety with dental patients:

1. Remember that anyone who sits in our chair could be struggling with holiday grief or depression. Approach each patient with a trauma-informed care mindset, being aware that our words and actions have the potential for re-traumatization.

2. Approach the topic gingerly. Whether you or the patient bring it up, have the conversation eye-to-eye at eye level. This may mean sitting the patient up. It may also mean that it puts you behind in the appointment. Sometimes, the vulnerable conversations we have with patients take precedence over things like OHI. It can also be worth running a few minutes late when we can build genuine rapport and trust with the patient that will last a lifetime.

As health care professionals who often have personal and deep conversations with patients, I recommend having 1-3 referrals to resources on hand that can help patients with mental health. These referrals may include local counselors or other organizations that offer support. Research your area for local resources. I recommend as a quality resource to find local counselors.

3. Avoid the cliches such as “They are in a better place.” Instead, choose empathy and connection, such as, “I can only imagine how you must feel,” or “I am sure you miss him dearly, and thank you for trusting me enough to talk about your grief.”

4. Avoid statements such as “time will heal” or “the hurt will fade with time.” Though these statements are intended to offer a sign of relief for the grieving, grief can show back up anytime as if it were brand new. Grief has a tendency to cycle in waves. I like to think of it as a storm that moves from the forefront of the consciousness to the background and back again. When the storm moves back in, to the griever, it can feel as if no time has passed.

5. Resist the temptation to tell your own story. Give the patient permission to take up all of the space in the conversation. When someone shares their pain with us, it is sacred, and the interjection of our own story may leave someone feeling dismissed or hijacked.

6. Ask if there is anything you can do to honor their loved one. Perhaps your family has a ritual such as lighting a candle on Christmas morning. “I will light a candle for your (insert name) on Christmas morning.”

7. Mostly, replace judgment with curiosity and proceed with empathy this holiday season. We all carry our own holiday burdens, and sometimes, it is easy to get caught up in the hustle and bustle of the season and forget what others may be carrying.

Happy holidays, hygiene family!

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GriefShare: If you, a family member, or a patient need grief counseling assistance, visit the GriefShare website for a group in your area. It is always free of charge.

Brave Like Ellie: To inquire about providing an Ellie gift box to a family, visit the Brave Like Ellie website.

Katie Palmer Project: If you know a family that would benefit from receiving lights, the nominations open nationwide each year in September on the Katie Palmer Project website. The project provides all lights, and labor is donated by local firefighters free of charge.


  1. Grief. (2019, April 19). American Psychological Association Dictionary of Psychology.
  2. Morgan, T. (2018, December 12). Are You Grieving this Holiday Season? Here are Ways to Cope with Loss and Honor Loved Ones. American Psychological Association.
  3. Ridling, P. Personal Interview, November 2023.
  4. Johnson, J. Personal Interview, November 2023.
  5. Bortzfield, D. Personal Interview, November 2023.

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Kandice Swarthout, RDH, LPC
Kandice Swarthout, RDH, LPC, is a Licensed Professional Counselor and Registered Dental Hygienist. She is a full-time dental hygiene educator in Texas, where she teaches community dentistry and research. Kandice is the owner of Inspired Education & Wellness, where she is a speaker, writer, and private practice therapist. Her unique blend of clinical expertise in both dental hygiene and mental health equips her to assist fellow healthcare professionals in recognizing not only their patients’ needs but also their own, fostering deeper connections with the healthcare community. Kandice’s dedication extends to her role as an approved provider for Texas Health and Human Services, specializing in human trafficking training for healthcare providers. Additionally, Kandice brings a touch of fun and camaraderie to the dental community as the co-owner of Muffins & Mimosas Dental Study Club. She offers engaging, in-person dental continuing education that creates a warm and welcoming environment for friends and colleagues to come together to learn. Read her articles in Today’s RDH column, Mental Health Spotlight. Contact Kandice through her website at or on social media @The Counselor Hygienist.