As hygienists, we see all kinds of patients and hear many stories from them. We know their life stories and their families. We are people-oriented which is the thing I love the most about dental hygiene. However, sometimes our patients say or do things that we aren’t expecting, and we have to come up with a quick, yet professional, way to respond. I have chosen a few of my favorite patient stories and quotes, and the professionally-correct way to respond, not the sarcastic thought that might come to mind first.
Do you sterilize your instruments?
This is one of my favorites. I really hope that the patient who asked this meant, “How do you sterilize your instruments?” Of course, patients have the right to ask about sterilization protocols and even to see the sterilization area. It’s a good thing when patients inquire about sterilization, as it directly affects them and shows they are looking out for the safety of their dental visit. However, sometimes the question just doesn’t come out right. Of course, being the sarcastic person that I am, the things running through my head to answer were, “We only sterilize instruments for every other patient” or “We sterilize instruments once per week.” Not everyone understands sarcasm or humor, so of course, a professional response was needed, as it is a valid question. The answer I gave without getting too technical was, “We use an autoclave which uses temperature and pressure to heat the instruments to the temperature which kills all bacterial life.”
A 40-year-old male patient sat in my chair, and the first thing he said to me is he doesn’t want me to use any new scalers, just old-school instruments and the harder I scrape, the better. My sarcastic brain immediately wanted to say, “No. For you we need to use the ultrasonic scaler, especially because you have rings of calculus subgingivally around each tooth.” However, what I explained to him were the benefits of using an ultrasonic scaler such as how the ultrasonic action lyses bacterial cell walls and essentially “kills” the bacteria in the biofilm.
In addressing the comment about “scraping harder” with hand scalers, I explained that excessive force doesn’t necessarily mean I’m doing a better job. My instruments are very sharp, and the goal is to remove bacteria-filled plaque and hardened deposits, not to damage tooth structure. I can do this through tactile sensitivity and only need to exert enough force to remove what needs to be removed.
Thinking I handled that pretty well, as I am scaling, he begins moaning and saying, “Yeah! Scrape harder!” His moans were very much like sexual moans. My sarcastic brain couldn’t even think of anything to say, as I was caught off-guard. In this situation, I felt the best thing to do was just to carry on and act as if every patient does this. I ignored it and got through the appointment as fast as I could while still being thorough. Before leaving the office, he told the receptionist he wanted the other hygienist next time because I didn’t scrape hard enough. Phew! Sometimes explanations of why we do things the way we do go unheard by patients. You can lead a horse to water, but you cannot make them drink.
That “dumb” dental floss
I once saw a patient when I was first starting at a new office. I had reviewed her chart; she had several 4mm periodontal measurements at her last visit. As I was probing and seeing much improvement, I asked her what she had been doing differently over the past few months. Her response was, “I have been using that dumb dental floss.” I resisted the urge to laugh out loud and told her it isn’t that dumb if the results are this good. A bit of humor worked well here!
What can we skip today?
The patient who asked this was a busy mom who was in a hurry. She wanted to know what we could skip to make her appointment go faster. I am thinking, “Should I skip cleaning your molar teeth and only clean the ones you see when you smile? Or maybe we could skip your oral cancer screening because that isn’t extremely important or anything?” All parts of treatment matter to give the most comprehensive and thorough care, so how do I skip anything? I ended up explaining how I could not skip anything giving the example of leaving out her oral cancer screening. I stated how the consequences of missing pathology could be detrimental, even life-threatening, to her health. I gave her an out too by saying, if she didn’t have time today, maybe it would be best to reschedule for a day that worked better for her.
As hygienists, we see and hear a lot of things in the chair. We only have a limited amount of time with our patients, which doesn’t give us much time to react to what they say or do. Thinking on our feet is very important in our profession. While light-hearted sarcasm and humor have its place, there’s always an appropriate time to use it. Knowing the difference is key. I keep a journal of what patients say to me, which helps me refer back and review how I handled certain situations. This journal has been a huge help at future appointments.