Tooth Shaming

It’s real, and we need to stop.

This is a topic I’ve been irked by enough over the past few months to write about it and share with you wonderful folks! So bear with me. I hope I don’t raise too many eyebrows or ruffle serious feathers.

Here it goes. A patient presents to your office for a new-patient consultation, with “sensitivity UR.” Your patient care coordinator schedules 30 minutes. It’s probably just buccal recession, requiring a sensitivity relief treatment of some sort, or a discussion on clenching or grinding. Pretty basic, right? Your assistant seats the patient and asks him or her to explain the problem. And then it happens.

As soon as the patient opens his or her mouth, the assistant tightens the mask a tad and puts on safety glasses. This patient has rotten teeth — significantly compromised, full-mouth rehabilitation, not “sensitivity issues.” The assistant politely tells the patients that the team will be taking a series of X-rays to find out what the sensitivity is all about. See, most assistants don’t like conflict. They don’t like to call the patient out (and most of the time, I appreciate that). Instead, they gather all the necessary diagnostic data and come running into your office.

“Dr. Murry, you’ll never believe this mouth. Plug your nose, double mask, wash your hands, put on your hazmat suit … it’s nasty.” Now there’s my assistant who I know and love! You take a look at the X-rays in your office; it’s always better to get the shock, awe, and four-letter swear words out of the way well out of patient’s view. You prep yourself, and off you go.

Introductions in the operatory, discussion of chief concern, and then into the intraoral exam. You don’t even really need to look. You know the story. But you oblige. Five minutes later, the mirror hits the counter, the gloves come off, the mask is pulled down, and your chair moves so as to be face-to-face with the patient.

Now stop. Time out!

This is where so many of us get it wrong. Ask me how I know. I’m seeing many of your patients because of it! I call it tooth shaming. There’s a fine line we have to dance along when presenting clinical findings of this manner with patients. Yes, they need to hear it honestly and sternly. And yes, it’s our duty to present to them our findings in regard to their dental health. But darn if we can’t do that in a way that doesn’t embarrass, anger, emotionally charge, or downright belittle a patient! I can’t even count how many patients present to my practice in tears, not because someone has hurt them during a dental treatment in the past, but rather, the dentist down the street they saw two years ago made them so depressed and upset about their teeth that they have been hiding from any dental office since then. Heck, the last one even told me the dentist laughed after looking at her teeth.

Are. You. Kidding. Me. Please tell me none of you have ever done that. A tooth is such a personal, vulnerable body part to most people. We have to harness this vulnerability and treat it as sacred. It’s not to be joked about. We can really mess with a patient’s mental and emotional well-being if we misuse or mistreat his or her trust. It’s an honor, really. And a privilege. Let’s not forget that.

They know they’re not in for “sensitivity UR,” but they are hoping we’ll ease it. They’re hoping they don’t have an experience like their last one. And, honestly, I’m going to come up with the exact same treatment as the last guy, but I’m going to make it a positive, uplifting experience. I won’t give away all my secrets to patient conversation, but needless to say, tell them it will be OK. I always lead with, “I have great news. I can help you!” Nothing in their mouth is anything we haven’t seen (or treated) before. And if it is, we know great specialists who can assist in the treatment.

So after those gloves come off, the mask is pulled down, and the chair is moved, take a two-second mental timeout. Take a breath, and turn on the tooth-shaming filter.

“Mrs. Jones, I have great news. I can help you!”

Donald Murry III, DMD