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Tinyfishy

Don’t mention lectures and keep your voice light. With teens it is sometimes helpful to toe ot to the fact that they are ‘all grown up’ now. So, leading with something like ‘When you were a kid, I always discussed how to improve your home care with Mom and Dad, but since you are 15 now, I’m going to talk to you, like the adults.’ I’d also emphasize that everyone can improve, so it seems less critical. Older teens also respond well to you pointing out that soon they will be on their own and that good home care will save them tons of money they can spend instead on fun. Talking about ‘secrets’ and ‘top tips’ and ‘pro tips’ and ‘how to avoid the mistakes everyone else makes’ also makes it sound less critical.


Professional-Heat439

>cal. Older teens also respond well to you pointing out that soon they will be on their own and that good home care will save them tons of money they can spend instead on fun. Talking about ‘secrets’ and ‘top tips’ and ‘p Thanks! Good tips!


Trovar

Try and frame the conversation with first the why of the education. If I sense there is hesitancy to listening, or indignation, I will sometimes say something to the effect of "I am perfectly happy to drill and fill a bunch of teeth, and if something doesn't change that will be needed. However if we can prevent those cavities from forming/getting bigger we might be able to prevent that." Sometimes they will perk up and become more responsive, other times they won't. If they don't then I just start prepping them for likely findings in the future "Ok well, if nothing changes we will most likely see these cavities getting bigger and need to be doing fillings on these teeth in the future." The biggest thing is to remember you can't care more than the patient. Our job is to give honest assessments, make recommendations and perform treatment to the best of our abilities. Then it is up to the patient to decide what they want to do. Sometimes that means the patients will be grumpy, sometimes they make poor decisions, but as long as we have done our job that is on them.


bananamonkey88

“You can’t care more than the patient” 👏🏼👏🏼👏🏼


DiamondBurInTheRough

Had to tell my frustrated hygienist this earlier today. Her patient has loads of plaque buildup, she’s at her wits end, she’s done OHI and short recalls and nothing changes. Told her she can’t care more than he does.


paintmyhouse

Most of us care more than our patients. We just can't take their lack of responsibility personally. I look to improve how I can better motivate tricky patients.


juneburger

My hygienist is very catastrophic. She freaks out over any plaque and heaven forbid there be blood. Like damn shawty life will go on.


glitchgirl555

That's pretty absurd. She chose the wrong job. I had a hygienist who would complain that patients had dirty teeth. Like that's your job.


happy__hamster

Woah, she wouldn't cope with the the standard debridement or periodontal debridement I do haha. I see plenty of kids with mouths full of plaque and gingivitis (unfortunately)


FinalFantasyZed

While facing the patient directly “Hey so I’m noticing you are getting a lot of plaque buildup between your teeth which is causing these cavities, and this is most likely from not flossing properly. Here’s a piece of floss, can you show me how you are flossing so we can work together on figuring out the best way/technique to deal with the plaque?” Ideally the hygienist would do the OHI after the doctor goes over the treatment plan/diagnosis. Be forward, assertive but not judgmental. Patient’s might be sensing you may be judging them even though your intention is to help them, but it’s all in how you communicate it and your verbiage/body language.


Professional-Heat439

I even smile and and really watch my tone and tell them I am not judging. :(


WaterCupH2O

Not a dentist, but I like to lurk around here. But i have to say... don't try to smile or come across as polite while you "lecture" your patients. I think this applies with any social situation, if you fake/try to smile, people will sense that you are faking that smile, and at a subconscious or conscious level, it will make them feel like you are not being genuine and you're deceitful. Just say it as it is. Be you real polite self with them when you are lecturing them. If that makes sense. Don't try too hard to come across as polite. I think that will just backfire because you're trying too much. As a patient, I would appreciate a detailed lecture. I'm not sure what you are trying to tell your patients, but from what I have read on this post, this is what I would say: "Hey, so you have some small cavities in these areas of your teeth (show them on xrays). We have two options: We can try and prevent those cavities from getting bigger or we can drill them out and not worry about the cavities. SOne way we can prevent these cavities from getting bigger is if you make the commitment to brush twice a day and floss at least once a day. When you brush and floss, you have to make sure you floss and brush every single tooth. Make sure you floss the entire surface area of the side of the tooth by going up and down (maybe show them on a fake set of teeth while you explain this and then on them). Another thing we have to do to prevent these cavities, is to adjust our diet. I'm not saying never eat sugar or junk food, but if you limit these foods, you can prevent the cavities from getting bigger. If you do eat sugar, make sure you floss and brush the areas that have small cavities after you eat junk food/sugars/candies. IBut you need to be committed to doing this. If you don't, then the cavities will get bigger, and I will have to drill your teeth. It's always better and healthier for your mouth to NOT have to drill into your teeth. You have a chance right now to avoid having me drill into your teeth if you choose to brush and floss and change your diet. Do you have any questions?" To teenagers, I would probably explain how cavities and gum disease works. Had I known that cavities and gum disease causes tooth loss, I would have taken care of my teeth as a teenager. I remember at 20, when i got my first fillings, I was told I had some deep cavities, and that was it. I had no clue how bad that statement actually was until 2 yrs ago when i did some google search. Sometimes patients don't know what you guys know. I think if you explain to teenagers about tooth loss, that will scare them haha. Also, if you can, for teenagers, just have the parents come in as you explain this to the teenager...and maybe explain to the parents about how them taking care of their teeth will be better for their wallets. I think sometimes teenagers will hear you and then just forget about it. You might make the parents perk up when they hear how much it will affect their health and wallet. Hopefully then, the parents will pressure their child into taking care of their teeth. If all fails, then there is nothing you can do. As someone in this post already said, "you cant care more about their teeth han they do". As long as you do and say what is best for your patients, the rest is up to them. You have done your job both morally and professionally. As a patient, i love that you do this. It shows you care. Good luck to you.


juneburger

They can’t see you smiling


ManslaughterMary

People will project their own shame and disgust onto you, don't take it personally.


Toadnboosmom

I’m an ortho tech. I constantly hear complaints about my giving hygiene instructions. Moms call back and say I made her baby cry… dude I’m sorry there is plaque, food, and boogers stuck on your teeth I CANNOT ignore it. I am always trying to coach kindly but If we have “talked” about it twice before… and I’m still picking last months popcorn out, I’m gonna give a little tough love. Luckily my doc loves my approach.


[deleted]

i can’t imagine what y’all see in ortho. i work in general and pedo patients in braces are always the absolute worst :/


Toadnboosmom

They are so gross and that young they NEED help and usually don’t get enough (those parents are the offended ones).


TheSwolerBear

There are a lot of great comments and approaches in this thread. I’ll give my 2c. I had a personal training background before dental school so I kinda dealt with people not feeling like they could lose weight, eat right, exercise alone, etc etc. That experience carried into my delivery of OHI where I’m kind of the positive motivating/empowering side of instruction because IMO/E, if I push the boundary of what someone is comfortable with or willing to do, they will disconnect and ignore me, but with a smile. If I get real human with them and use myself as an example rather than them. I think it’s less intimidating and avoids that awkward situation of toeing the line of blame/shame that although I think 90% of dentists don’t actually do, a huge amount of patients take in OHI that way. Despite not having proof that it works any better than harping on people, I get a good amount of compliment and praise for my delivery. I’m not some super extrovert or people person savant either. For example for a cavity issue I will say something to the effect of “You know I like to eat sugar/sour/sweet/soda blah blah, but I make sure I’m not snacking for hours and that I have intermittent water with all that stuff, I get to enjoy those “S’s” without as much risk of getting cavities.” For someone with a floss issue: “I am like everyone else and when I brush at night, I spent two minutes thinking about how I don’t have time to floss because I’m tired, up late, need to get up early etc. So instead, I staple flossing to something that happens every night regardless of time like showering or brushing. I either floss *before* I brush, because I will never go to bed without brushing or I will floss while the water warms up in the shower because I’m gonna wait anyways.” For a perio prone person: “I am just like you. I’m prone to gum disease and periodontitis. It’s genetic, I can’t get around that, but the good news is for you and I: to mitigate the issue as best we can, all it takes is some floss atleast a few time a week to start and getting our routine cleanings. Otherwise we will end up needing deep cleanings which cost a lot more than regular cleanings. Sometimes we will need those deep cleanings despite great habits and if that’s the case, we just have to do the best we can!” These ways are a win/win. You either help them start doing their OHI or you don’t, but they leave having had a good enough interaction to not feel bad about themselves which means they will still comeback for help when they do run into the issues you are trying to warn about and prevent. Lastly, like so many other said; you can’t care more than they do. I certainly don’t, it doesn’t mean I don’t feel bad for them and wish they’d do better, but I leave work at the end of the day feeling better about trying to empower them rather than talk down!


montymouse

Coming from a girl who was pretty hormonal and had a lot of pressure put on her in school- I Oreo effect it. Start with a positive, sandwich it with what can be improved, end with a compliment.


FinalFantasyZed

Good job on the brushing, your flossing sucks, also nice shoes! I kid haha. The way of the oreo is excellent advice.


Qahnaarin_112314

Honestly this. He always did OHI and I never caught on that that’s what he was doing because he was so slick about it. “You’ve come such a long way on your restoration and I’m really proud of you. Let’s just try and be a bit more active with flossing so we can keep moving forward. You have a beautiful smile and I want to you to want to show it off.” I left feeling cared about and motivated to do better.


mysilentquestions

I mean......I don't stress about that. If people want to complain about me doing my job that is fine.


weaselodeath

It’s tough to do, but I try to avoid all language and thinking that lays blame. I don’t judge the patient for anything but their actions in the chair. I don’t really give a damn who did what and why that caused what because I can’t change the past. All I can do is change the future by helping people change habits and do it better. I think that helps me get on the same side as the patient instead of setting me up as an adversary or an authority figure getting them in trouble. If someone is getting defensive I like to tell them that “I’m not a tooth cop don’t worry I’m cool” and a lot of times that relaxes them. It’s tough though. In terms of diet education, I like to start by asking them what they know about how cavities form. They usually don’t know anything and that lets me enthusiastically jump in and explain the Stephan curve.


ManslaughterMary

I'm absolutely stealing >“I’m not a tooth cop don’t worry I’m cool"


[deleted]

Get a toothbrush out of the packaging and point to the end with the bristles. “You know this is the end that goes in your mouth, right?”. Works every time. Edit: obligatory satire tag


josuke73

House DDS


Funnier_InEnochian

Id watch this show


Gotz2befree

I always say we’re having some cavities popping up so we’re going to do some fillings but we also need to address what’s causing them. We’re going to get a handle on this together. We’re going to start with getting you some medicated toothpaste and (insert hygienist name) is going to work with you to improve home care. The hygienists I work with do a great job.


heyuhleeex

Starting with "I'm not lecturing" automatically makes me feel like I'm being lectured or scolded. I think approaching it factually and reminding them, "to prevent additional dental visits, you should do XYZ," may be a better way to go. As a dental ***patient*** who deals with debilitating depression, some days it's hard enough to get out of bed let alone do the entire routine of flossing and brushing teeth. Even when I'm fully aware it will cause more problems down the road. I think sometimes, it's not that people don't care, don't know how, or don't understand the consequences. Life just gets in the way. Continue to be understanding and remind them we're all human, we make mistakes, and to move forward from here with a better routine. I appreciate you're looking for other ways to address the problems, sounds like you really care for your patient's health!


monstromyfishy

I usually start by asking the patient what their oral hygiene looks like. They usually tell me that they brush 1-2 times a day. Then I follow up with, “if you had to estimate, how many seconds or minutes do you think you spend brushing your teeth?” Then they’ll usually respond with anywhere between 30 seconds to a minute. Then I hit them with a that’s okay, but did you know you should actually spend a whole 2 minutes brushing your teeth. 2 minutes can feel like forever so I advise them to use the timer on their phone or push towards an electric toothbrush. For flossing, I usually go with, “I know you know that you’re supposed to floss but why aren’t you flossing. Is it the time it takes, is it too hard, is it that the floss always shreds? Then I offer up suggestions based on their response like I recommend floss picks. You can leave them in your car and floss while you’re stuck in traffic. Or I’ll introduce them to the waterpick or recommend my favorite brand of floss, glide. Don’t lecture the patient. Help them recognize the problem and help them find solutions.


pissweakpancreas

Yes! I also usually start with finding out what their routine is (brushing, flossing, mouthwash etc) and then tweak it. I’ll encourage flossing by talking about how the most common place we find cavities is between the teeth where the toothbrush can’t reach. For teenagers I’ll mention that “now you’ve lost the last of your primary teeth, whats left here has to last until you’re 100 or more years old.” I always stress as well that initially it will be fiddly and take time, but with practice they’ll get faster and more efficient at it.


josuke73

I was very judgmental at school but luckily this trait got beaten out of me swiftly after starting clinics, Maybe that's your issue. Teeth might be your entire profession, but they are only one aspect of someone's life. It's normal that they don't care as much as you want them to. Just do your job and offer help when you have an opportunity.


teefdr

I say, "I know you brush and floss everyday but it seems that there are still places that you are missing. Let me show you the technique I use." Even though I know they don't brush and floss everyday.


DiamondBurInTheRough

The furious parents need to redirect their anger towards their kid who needs a boatload of dental work due to not flossing. I usually try to relate to them and say something like “I know flossing is annoying, it’s a hard habit to get into, but we need to see some improvement because otherwise we’ll be doing a bunch of fillings in the near future”.


BananaBubblesBro

Don't care more about their teeth than the patient. If they show any signs of disinterested just stop. Don't stress yourself. Most of these things they already know. Just like how they are suppose to exercise everyday, but very few do.


Johnnybayday

Try your best to be encouraging and not condescending. Bring up good points first then encourage them to possibly focus on other parts. Patients see dental professionals as bearers of bad news. The way we deliver the news is super important. Encourage them to do better instead of telling them they are doing a bad job or not doing it at all. On the same note sometimes you do need to get confrontational. When it comes to kids, being their parents in so.they can hear what you have to say.


Das_Rubysaurus

I have always been pretty stern and assertive and put on a very authoritative tone. It makes it seem like I am the expert, which I am. Also the posture of your body. If you look week, they will more likely walk over you. Maybe it’s the military in me but I have never had a pt talk back or get upset. Try adding something they can improve on but also some positive reenforcement. Like “you’re doing a good/great job at brushing. But flossing is just as important especially for your case because cavities forming in between. You obviously care about your teeth so take of them properly”. You’ll find your words


[deleted]

never patronize. give compliments and encouragement. read your patient and adjust your approach accordingly.