Dental Hygiene - One Part Clinical, Two Parts Psychological
By Carol Tekavec RDH
Some days it seems as if every patient scheduled has an emotional issue with dental treatment that must be addressed. While many people are calm and fine with having dental care, some are nervous, anxious, worried, jumpy, or just plain resistant. Having someone poking around in your mouth is an invasion of a very personal space. Our mouths are essential in our ability to communicate, eat, speak and be understood, and are vital to our appearance. Healthy teeth and an attractive smile are central to beauty. It is no wonder that a person can be nervous about having their teeth worked on. While it would be nice to simply get down to work and perform our prophys and SRP services, many times the psychological concerns of a patient must be addressed first.
The Resistant Older Patient
Many older patients are very happy to accept scaling and root planing and then subsequent appointments for periodontal maintenance; but a few will balk at the idea. Their thought is “I don’t have long to live, I don’t want to spend money on my teeth.” This can come from a patient in their early sixties! Comparing dental services to regular maintenance on a car can sometimes be effective. For example: A year 2000 car may be fourteen years old, but still run in excellent condition. If that car needs to have new tires, would you keep driving on the bald ones because the car is “old”? With new tires, the car may be going strong for many more years. Scaling and root planing, plus regular maintenance, can give your teeth and mouth years of health. Investing in your oral health is at least as important as investing in your car.
The Health Conscious Adult
Being concerned about one’s health is a good personal quality, but sometimes a patient can present with a long list of concerns about their dental treatment that can make caring for them a challenge. They may express worries about fluoride, radiographs, sealants, resins, anesthetics, and lately even gluten. Taking the time to provide detailed information about what items and products are going to be used during their treatment can often satisfy this patient. The worst thing to do is minimize or belittle their concerns in any way. Be prepared with an information sheet about the resins, anesthetics, etc. that the office uses and don’t rush your explanations. Armed with the facts, these patients are often more than ready to proceed with their dental treatment.
The Jumpy Little Child
Some children are so anxious about their dental appointments that they flinch when you gently touch them on the arm! They are a challenge. The “Show-Tell-Do” approach can often help. Before proceeding with any treatment at all, have them hold a mouth mirror and peek into it, turn on the prophy angle and show them how the prophy cup works on a fingernail, turn on the suction and let them hold it and feel it on the outside of their cheek. Show them the air/water syringe and describe it as a “squirt gun”. Let them squirt it! Let them pick out what flavor of prophy paste they want, as well as what flavor of fluoride they prefer. Turn cartoons on the treatment room TV. If the chair light bothers them, offer sunglasses. If they have specific requests, try to honor them. One little patient of mine was ok with receiving bitewing x-rays if he could cover his eyes with his hands. Again, taking the time to try and find out what is worrying them, and then letting them know what is going on, can be all that is needed to allay their fears.
The Super Jumpy Adult
Adults can be just as anxious as children, particularly when it comes to the injection. Topical anesthetic used prior to the “shot” is a must. Also, using the technique of slow dispensing of the anesthetic and calm conversation on our part during the injection works to calm many. However, sometimes these efforts are just not enough. The Jumpy Adult, like the Jumpy Child, will often react to just about any touch with a “pain” response. These patients often benefit from listening with headphones to their choice of music, or again, looking at a program on TV. While distraction works for most, it doesn’t work for all. One of my patients benefitted from me telling him that I would describe every step I was taking during the injection process so that he would know when the actual “shot” was going to take place. He also did not want any euphemisms for “shot” so I told him: “I am now going to pull your cheek to the side. I am now holding the shot. I am placing the needle. Now I am injecting.” While this format would not be useful for many people, it was just what he needed and we got along well.
Taking care of patients is more than just taking care of their teeth. Acknowledging personal needs and concerns and addressing these as best we can is important to providing the best care possible.
Carol Tekavec RDH is the Director of Hygiene for McKenzie Management. Carol can improve your hygiene department in just one day of training “in your office.” Interested in knowing more about how to improve your hygiene department? Email firstname.lastname@example.org.
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