Troubleshooter: How to handle disgusting patient noises at cuspidor

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QUESTION: We have a few patients who, when asked to rinse, make the most disgusting noises. They are so loud they can be heard throughout the entire clinical area. It sounds like they're hacking up hairballs. I won't describe how revolting it is to clean the cuspidor after these patients. I feel bad for the other patients who have to listen to this disgusting noise, and it totally grosses me out. I've been tempted to ask them to stop but I don't know if that would be rude of me.

ANSWER FROM ANY SMITH, Amy Smith Consulting:
I can understand why this is stressful for you, and I'm sure you’re not alone. Let's look at possible solutions:

• Can you talk to your employer about upgrading your equipment to a newer model that eliminates the cuspidor? He or she might be able to take advantage of a 179 tax exemption on new equipment. Your equipment representative or tax accountant can help with this.
• If not, is there a way to add some sort of sound proofing to your operatory? Perhaps music or some other kind of noise reduction option? I understand this doesn't help you much, but it would benefit other patients in the office.
• Is there something else you can do to help patients rinse better or easier? For instance, when seating patients, show them the control, usually a button, that allows them to refill their cup when rinsing. This ensures they know the’re not limited to just one cup of water.

You may have thought of these possible solutions already, and if so, the answer rests with your doctor. Make sure he or she understands your concerns, especially as it relates to other patients, who might not be saying anything but are likely uncomfortable about the noises as well. But they can walk away. You cannot. Good luck!

ANSWER FROM JAN KELLER, Jan Keller and Associates:

I can certainly understand how this might be an uncomfortable situation for you. Here are my thoughts:

• Is there a need to upgrade your equipment? It's not possible to tell how old it is from your question, as even some newer units include cuspidors. Start there with your employer, whom I'm sure would be sympathetic to your situation and interested in the overall comfort of all patients.
• You mention you have “a few patients” who do this, which makes me think you know who they are, and you can possibly get ahead of the problem. When you talk to them, be very specific about how they rinse, for instance, tell them "gently,” "a little at a time,” or “use small amounts of water and repeat often.” Make sure there is adequate water available to them.
• Can you offer more suction/cleaning before rinsing? Would it help if the patients stood to rinse their mouth at the sink?
• Does this bother any other team members? If so, that's even more reason for your employer to help you find a solution.

While I know this is probably not an everyday occurrence, if it is affecting the comfort of your team and other patients, it should be addressed as soon as possible. Not acting can be costly in terms of patients who simply leave and never come back, and offer no explanation.

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Send your questions for the experts to answer. Responses will come from various consultants, many of whom are associated with Speaking Consulting Network, Academy of Dental Management Consultants, Dental Consultant Connection, and other expert dental support and human resources organizations. Their members take turns fielding your questions on DentistryIQ, because they are very familiar with addressing the tough issues. Send your questions to [email protected]. All inquiries will be answered anonymously here on DIQ.

Originally published in 2016 and updated regularly.