“You need to make sure that you are wrapping the floss with a soft C-shape interproximally and getting the distal of those back teeth.” From a clinical standpoint, the instructions were correct. From a patient’s standpoint, they were likely confused.
I overheard this exchange while working with another hygienist. Later that day, when the opportunity arose, I gently pulled them aside and shared a concern. The technical jargon they used, while perfectly appropriate in a classroom or clinical discussion, was likely to go over the patient’s head. It could also unintentionally make the patient feel as though they were excluded from the conversation, resulting in withdrawal.
To this hygienist’s credit, the feedback was welcomed, and they admitted that no one had pointed this out before. It was a simple conversation, but it highlighted something we sometimes forget in clinical practice – being knowledgeable is not the same as being understood.
As dental professionals, our responsibility is not only to deliver information but also to ensure that our patients understand it. Clear communication is just as important as clinical skill. The most thorough explanation is ineffective if the patient leaves the chair unsure of what was said or why it matters. This means adapting our language to the individual sitting in front of us. With a young child, we might describe bacteria as “cavity bugs.” With a medical professional, we may discuss bacterial levels or infection more directly with clinical terminology. Neither approach is wrong – they are simply different ways of delivering the same information in a way that resonates with the listener.
Shifting the Patient Experience
Our role is to educate patients about their oral health status and help them understand the risks and benefits of their daily habits. We should create an environment where patients feel comfortable enough to engage in that conversation.
Patients may walk into a dental office carrying some level of anxiety, shame, discomfort, or fear. Sometimes this comes from their own past experiences, or perhaps from stories shared by friends or family. Whatever the source, we have an opportunity to shift that experience by becoming a friendly ally rather than another authority figure. When we rely too heavily on technical terminology, patients may feel intimidated or believe we are speaking down to them. This could cause them to withdraw, nod politely, or simply stop asking questions. In some cases, they may even withhold important information about their oral hygiene habits or concerns.1
Of course, this does not mean we should speak to patients as if they are incapable of understanding. Rather, we should aim to communicate clearly and respectfully, ensuring the message we deliver is received and understood.1
Strategies for Intentional Communication
Dental hygiene appointments are packed with assessments, procedures, and education, making it easy for patients to feel overwhelmed. To ensure our message is received, we should be intentional with how we deliver information. Something as simple as slowing our speech, using a calm tone, making eye contact, or positioning the patient so we can speak face-to-face instead of over them can change the dynamic of the interaction.1
Visual aids can also be powerful tools. Handing a patient a mirror or showing them intraoral photos allows them to see what we see, turning the conversation into a shared discovery rather than a lecture.1
Open-ended questions and active listening can further help. Asking follow-up questions, maintaining eye contact, and occasionally repeating what the patient has said ensure they feel heard and understood.1
Language choices also matter, as statements that sound accusatory could immediately put patients on the defensive. For example, saying, “You are not flossing. I can tell because there is a lot of bleeding,” may shut down the conversation before it even begins. A more constructive approach might be, “I’m noticing quite a bit of bleeding, especially between the teeth. Can you tell me a little about your daily flossing routine?”2
This simple shift invites honesty and opens the door for meaningful education. It allows us to learn more about the patient’s habits, the type of interdental aid(s) they use, or whether they might benefit from demonstrating their technique, so adjustments can be made.2
Addressing Barriers and Tailoring Recommendations
Sometimes patients admit they are not cleaning interdentally consistently. When that happens, asking about barriers can be incredibly helpful. Many times, the obstacle is not a lack of motivation but something far more practical.2
For example, some patients say they intend to clean between their teeth before bed but are simply too exhausted by the end of the day. In those cases, suggesting that they keep floss (or whatever interdental aid they use) by their bedside may improve consistency, even if it isn’t ideal. Others may find it easier to clean interdentally after dinner while watching TV, winding down for the night, rather than immediately before bed. This shift may even help them reduce late-night snacking and complete their oral hygiene routine before fatigue sets in.
If we become too focused on getting through the appointment or staying on schedule, we may forget to consider the patient’s perspective. Simply telling someone to “floss more” is rarely constructive. Opening these conversations shows patients that we care about understanding their challenges so we can help them succeed with tailored approaches.1,2
Providing Clear Explanations
Making information relatable can also help patients connect with what we are explaining. I often use simple analogies or explanations when discussing gingival bleeding. Some patients may believe that bleeding during interdental cleaning is normal because it happens so frequently. I remind them that while it may be common, it is not healthy.
To help them understand, it can be explained that when bacteria are left undisturbed for long enough, they can cause irritation and infection. In response, the immune system sends extra blood to the area containing cells to fight the infection and destroy the disease-causing (pathogenic) bacteria. This inflammatory response causes the gum tissue to swell and become more prone to bleeding. When you clean between your teeth and see bleeding, it often means you’ve just disrupted bacteria that had been sitting there long enough to irritate and infect the tissue. The more consistently you disrupt those bacteria, the more opportunity those areas have to heal and the bleeding to stop.
It takes only a moment to explain this, but it gives patients a clearer understanding of what is happening in their mouths. When patients understand both their oral health status and how our specific home care recommendations address it, they may be more likely to take ownership of their oral health and make changes.1
In Closing
While clinical terminology is necessary for our chart notes, if it isn’t understood by patients, it likely won’t drive change and lead to better oral health outcomes. Instead, we can help create an environment where patients feel comfortable by focusing on how they feel, how clearly we explain their health status, and whether they feel supported in improving their oral health.
Sometimes, the most powerful tool we have in dentistry is not an instrument at all – it is the way we choose to communicate.
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References
- Ho, J.C.Y., Hui, J.C.Y., Chai, H.H., et al. Transforming Dental Care Through Empathetic and Clear Communication: A Comprehensive Review and Implementation Framework. Dent J (Basel). 2026; 14(2): 111. https://pmc.ncbi.nlm.nih.gov/articles/PMC12939114/
- Chunda, R., Mossey, P., Freeman, R., Yuan, S. Health Coaching-Based Interventions for Oral Health Promotion: A Scoping Review. Dent J (Basel). 2023; 11(3): 73. https://pmc.ncbi.nlm.nih.gov/articles/PMC10047453/
