Magic 8-ball, what are my dental patients thinking?

Playing with the magic 8-ball was so much fun when I was a child. My friends and I would ask it the craziest questions, like “Will I marry Mr. Brady?” and laugh for hours about the responses. It’s comparable to the questions I now ask Alexa just for giggles. Here’s a list of 8-ball answers.

If I had a magic 8-ball now, I’d ask, “What are my patients thinking?” One of my absolute favorite things about the dental hygiene profession is working with many different personalities. I’m grateful for all I’ve learned about myself and the human condition.

Types of patients

Much to my family's chagrin, I’ve always been an armchair psychologist. Early in my career, I noticed how often the dental chair becomes a truth chair. Patients often confide in me and share their heartbreak, insecurities, and failures. I’m happy to be a sounding board or shoulder to cry on.

Then there are the ritual patients. They slip off their shoes, remove their contact lenses, and loosen their belt. (Yes, that’s a strange one. I wasn’t sure where he was going with that.) I find these patients quirky, but they don’t bother me beyond that.

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How about the super sweet patients who are always happy to see me and deliciously pleasant to be around; are they for real? How on earth do they do it? We could all use more patients like them.

Then there are the patients who are way too quiet. It’s often the uncomfortable quiet, the kind that leaves me feeling like I might have said or done something wrong. They’re the patients who respond to your questions with one-word answers and make you feel like you’re walking on cheap veneers. Trying to mind read is draining and trying to get my stomach to shut up after lunch is nearly impossible. The quiet patients have always been the toughest for me.

Some patients have commented on my gift of gab and are surprised that I don’t like the quiet ones because then I have more time to talk! But appointments with quiet patients seem to last forever. It’s not just the quiet; there’s something else. It’s hard for me to put my finger on, but it feels a bit like contempt or a bad vibe. I know I shouldn’t take it personally, but somehow it feels very personal.

Change can be painful

I can’t recall why or when I decided to change things up, to try to connect with my quiet patients in a more meaningful way. One day, I decided to approach these appointments differently, and true to form, I started with my most dreaded patient. Why not? Zero to 60 can’t be that bad, right? Sometimes I’m not the sharpest 204 on the tray.

In the beginning, it was painful. I started by gingerly asking, “I was wondering, does anything I do cause you pain or make you feel uncomfortable?” Oh boy, the looks I got initially. Several patients asked me if I was serious, and to be fair, I tend to joke around a lot.

I find that much like starting a new job, changing anything in my treatment process can be uncomfortable. I’ve learned to accept the discomfort as part of the process and not get caught up in “this isn’t working” too quickly. If I allow them to, these uncomfortable starts can impede significant progress. It takes patience and gumption to change.

I've learned we need to ask patients if they experience pain during their appointments. If we can do something to alleviate the pain, we should. I'm often surprised by the responses I get. Some patients told me they had a fear of drowning!

Patients don’t know their appointments can be different

It’s easy to accommodate the vocal patients, but how to accommodating the quiet patients? Is it fair to grab a desensitizing agent or anesthetic only for those who complain? The quiet ones may just be trying to get through the appointment as best they can. I’ve been guilty of this. Have you?

People tend to form their tribes with like-minded people. We like our tribes to celebrate the things we want to celebrate and hate what we hate. Most of these uncomfortably quiet patients dislike going to the dentist, and many of their friends dislike it too. They may interpret that as everyone hates going to the dentist, so they need to just grin and bear it. On the other hand, I loved my dental family as a child, and I thought everyone enjoyed going to the dentist.

Having a quick conversation around what may cause patients' pain is not only worthwhile; it’s the standard of care. How should we care for their pain? Ask, “Does anything I do cause you pain?” If the patient says yes, try to find a solution. New products hit the market every year, including a fun technology-driven alternative to topical anesthetics. I urge you to keep whatever you have handy, so you’ll be more inclined to use it.

I make it a priority to let my patients know I care about their pain, and I will address it. This small investment will pay off in huge dividends in the form of trust, loyalty, cooperation, and case acceptance. Then just maybe they’ll be able to keep their contacts in and their belts fastened at their appointments.