“Hi, I am Dr. Hung. I am here to check your wisdom teeth. How are you feeling today?” I walked into the treatment room, greeting my new patient Amy.
“No offense, but I just hate you guys. I hate dentists.” Amy had her knees up against her chest, curling into a fetal position in the treatment chair. She cringed in disgust. She looked uneasy and she shivered. She then told me about how she had three unsuccessful root canal treatments in the recent past and how she couldn’t get numb when her last dentist tried to work on her.
How many times a day have you heard “I hate dentists?” Regardless of age, ethnicity, gender, country of origin or language spoken, the fear of dentists seems universal. In dental school, we learned in neuroscience that the homunculus has a large mouth and big lips; there is a dense sensory distribution in the oral cavity, making it ultrasensitive. Pain avoidance and fear for the unknown, plus unpleasant past experiences, amplify the mistrust and anxiety in patients. As you know, many patients nowadays Google Internet information and watch YouTube videos before their procedures, expecting the worst outcome. The TV and movie media perpetuate the negative stereotypes of dentists. The horror: “The Marathon Man” (1976); “The Dentist” (1996); the wimpy and the incompetent (“I am just a dentist”) in “The Whole Nine Yards”(2000) and its sequel “The Whole Ten Yards”; “Hangover” (2009) and its sequel “Hangover Part II”. Are we already at a loss before we can prove to our patients that we are trustworthy, knowledgeable and well-intentioned?
I recommend the following steps to help lessen patients’ anxiety and fear. In reviewing the patient’s past medical history and history of present illness, one component that is paramount to the discussion is the patient’s past experiences with dentists and dental treatment. Once you understand the patient’s past experiences, it would be easier to establish the patient’s expectations based on their past experiences.
Consider using the following steps to guide your conversation:
- Reassure the patients that you are just talking to understand their concern: “I am not doing the procedure right now. I just want to chat with you to understand where you are coming from.”
- Ask them if they had bad experiences in the past with their dentists or dental treatment. Ask specifically what bothered them the most. Was it the injection? Was it the drilling noise? Was there any post-op complications of pain, swelling, bleeding or infection? How can I make it better?
- Ask them if they had any good experiences that could help you to model after. For example, “I did well with laughing gas.”
- Consider adjunct anesthesia methods, such as enteral sedation, nitrous oxide administration and/or intravenous sedation, within your scope of practice and training.
- Establish clear expectations with patients. Fearful patients don’t want to see, hear or feel anything. I set up expectations with my patients that “It is not reasonable not to feel anything at all.’ “The numbing jelly makes the injection more tolerable.” “You should not feel pain after the local anesthesia.” “You might feel pressure or vibration when I work on you, even if you are numb.” You might hear noises.” “This tooth will be a little harder to numb.” “We will make sure to spend some extra minutes making sure you are comfortable.”
- Tell, show and do: is a great tactic for not only pediatric patients but for adult patients as well, especially those who are fearful. Verbally reassure your patients along each step of the way. Avoid surprises.
“I don’t hate dentists” campaign
Despite the best of efforts, it is daunting to have to hear “I hate dentists” all the time. Imagine when someone visits a restaurant, walks straight to the kitchen and says “I hate chefs.” Imagine when someone walks into the Microsoft store and says: “I hate IT support guys.” Imagine how awkward it must be if you are in a social situation, a stranger walks up to you and says: “Hi, my name is John. No offense, but I hate you.” The social context of dentist-loathing seems to be of a more acceptable fallacy due to the shared public perception of discomfort, pain or possible failure as related to dental treatments.
In the past few months, I initiated a campaign in my office, called the “I don’t hate dentists” campaign. I customized a hat that is embroidered with the message “I don’t hate dentists”. My staff members wear them to greet the patients and pique patients’ curiosity about this hat. I have a coffeehouse chalkboard in my reception area displaying all three basic rules on the board for all the patients coming to my office:
- Rule #1: Don’t tell us you hate dentists.
- Rule #2: Tell us something you like about our office.
- Rule #3: We will tell you something we like about you as a patient.
Patients then are entered into a raffle to win the hat if they follow these three basic rules. New patients are welcomed to spin the colorful wheel in my reception area. Since I began to run the campaign a few months ago, I have not heard of anyone saying to me “I hate dentists.” I make sure I address their fear and concerns and try to come up with treatment plans that can help them to get over the hurdle in order to establish great experiences. By redirecting patients’ behavior, there is more positivity in the office. I feel that by turning the reception area into a more positive environment, I can be a much better practitioner for my patients.
Make sure to get your entire team involved running this campaign as your team members often are the first ones to greet the patients. The campaign will be light-hearted and fun. Your patients will appreciate your efforts in making them feel less nervous. Most get a kick out of the hat and its message.
I encourage you to join my “I don’t hate dentists” campaign today! Many of my colleagues have asked me about this campaign, therefore, I am sharing with you. Together, we can promote more positivity in the office and change patients’ perceptions, one hat at a time.
Dr. Y. Cathy Hung is a board-certified oral and maxillofacial surgeon and the owner of Prospect Oral Surgery Center in Monroe Township, New Jersey. She was a member of ADA Institute for Diversity in Leadership class 2019-2020. She writes posts, blogs and articles on practice management and clinical topics and received a Lifetime Achievement Award in 2010 from “World’s Top 100 Doctors” by Global Summit Institute, which practitioners representing more than 70 countries in the world.