How 'little' words can make a big difference in dental patient treatment acceptance and understanding

Did you ever hear the axiom “you can’t be a little bit pregnant?” In other words, someone either is or is not expecting. There is no in between.The same is true for most dental disease.

One can have early or isolated periodontal disease, or tooth decay that is very shallow or very deep. But the fact is, the disease is present, and it needs to be addressed and arrested regardless of the stage it is in when we find it.

Knowing this to be true, why do we frequently tell patients they have a “little bit” of perio, or “kind of” a cavity, or “just some” gingivitis?

It may seem as if I’m being overly critical of clinician communication, but the fact is, those “little” words often make a difference in a patient decision to accept treatment.

When we use what are called “minimizing words” to describe treatment, our words work against what we are trying to accomplish, which is to ensure the patient accepts treatment. We are downplaying our findings. We devalue our recommendations. Why do we use minimizing words if we know they are not in our patient’s best interest? Habit is part of it, but I believe it’s because our intentions are good. We want to soften the blow. We may even be afraid of a patient’s reaction to bad news.

For example:

“Mrs. Jones, you have a little cavity. It’s really no big deal. We can go ahead and schedule to fix it if you’d like. It’s kind of important to fix it early.”

versus:

“Mrs. Jones, you have a cavity. It is in the early stages, and still isolated to one part of the tooth. I recommend that we fix it now, so it does not grow larger, which it will.”

In the first example, the well-intentioned clinician has inadvertently all but talked Mrs. Jones out of having the cavity filled. I want to make the distinction between involving patients in their treatment decisions and putting what should be an expert opinion concerning treatment squarely on their shoulders.

We should educate our patients and allow them to make the choices that are comfortable for them. However, if we provide them minimal or downplayed information and then ask them to decide what is best, we are doing patients a disservice. State your recommendations clearly, and then allow the patient to make a decision when they are armed with the facts around their particular treatment need.

It might help to remember the following:

• Patients will like and respect you more if you are honest and confident.

• Patients come to you for your expertise. It’s OK to be the expert.

• Minimizing words may actually talk patients out of having treatment. “Why is this filling going to cost me over $200 if it is ‘just a little’ cavity?” “Why should I take time off of work to have a two visit cleaning if its ‘just some’ gingivitis?”

• You can make your diagnosis unnecessarily confusing for patients. “If I have just a little gum disease, should I wait a few months before I treat it, or treat it now?”

Practice avoiding minimizing words. Confidently stating the importance of timely treatment and prevention is really caring for your patient. There is no minimizing that fact!