After hearing me break the bad news to a recall patient, a good friend reminded me that I didn’t cause this patient’s decay. Simply put, she heard apprehension in my voice. And if she could hear it, my patients could also hear it.
This was a turning point, a shift in my thinking. I no longer have the sick feeling in the pit of my stomach when I have to tell someone they have a cavity, or worse. “You have a cavity and this is how we can handle it.” Straight forward, no wincing, no sing-song voice, and no gut wrenching flip-flop.
Why, then, are patients so suddenly surprised and upset when I tell them they have a cavity? It’s comical really, isn’t it? Somehow it’s now MY fault that they have a cavity. I didn't go to their home and zip tie their hands together, making it physically impossible to care for their own dentition over the last six months. Nor did I force feed them highly acidic drinks and jam their mouth full of taffy. They've not flossed (sans the corn on the cob at the barbecue beach party and Grandma’s roast beef dinner) since their last hygiene appointment, but hearing that they have decay blows their mind. Then there is the patient that suddenly presents with the toothache and they are astonished to hear it isn’t “just” a filling. (Thank goodness for the intra-oral camera!) Or better yet, when more than half the tooth was lost when that “little filling” broke last Christmas (or was it the Christmas before that...?).
Let me point out that I do have compassion for patients that struggle with dental disease, especially those that are truly doing all the things that are recommended without significant improvement.
But I USED to feel really bad–responsible even–when I had to “break the bad news” and would struggle with how to verbalize it. I had to make that switch in my brain: I didn’t CAUSE this problem; rather, I am, in fact, the person who can fix it. Once I did, things got exponentially easier and better for me as a practitioner. I’m more self-assured and confident when discussing my diagnosis with patients because I don’t have any emotions tied to my patients’ dental disease. It is THEIR dental disease and their responsibility.
I only wish I had heard it earlier in my career. But as the saying goes…
Better late than never.
Colleen DeLacy, DDS, FAGD
Michigan
This article makes a great point. The best way to navigate this tricky situation is by making sure the patient knows you are there to guide them in making the right decisions for future care. Patient trust is so important, and this post definitely highlights a tough area of that relationship with some great pointers for how to overcome the situation in a way that benefits both parties.
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