Letter from the editor: April 2026

There’s something about the eyes that gives everything away. 

We can say the right words. We can follow the script. We can even deliver what sounds like the perfect treatment plan explanation, but if our eyes don’t match what we're saying, patients know. They always know. 

Patients are paying attention in ways we don’t always give them credit for. They are not just listening to what we say. They are aware of how we say it and can usually tell when we are trying to convince them of something we have not fully convinced ourselves of. 

This is especially true in the op. Clinically, our eyes are often the only part of our face patients can see as our masks, loupes, shields, have covered everything else. So whatever we are thinking, feeling, or are unsure about is what patients are reading in our eyes. 

The message for this month is about honesty and clarity that is rooted in preparation and knowledge and ends in accountability. It's about those moments that happen in every dental office that are just fractions of a second but change the trajectory of the patient experience and often how we feel about ourselves. 

We need to know what we are doing before ever picking up an instrument. No guessing. No hoping it works out. Preparation, repetition, and understanding our role well enough that when we step into it, there is no doubt—is key. Because patients can feel doubt, even if they cannot explain it. And it is not just from the dentist’s chair; it extends throughout the office. 

How many times have we seen and discussed a scenario where the doctor finishes explaining something to a patient, steps out of the room, and the patient immediately turns to the assistant or the hygienist and asks for an explanation or if they really need the treatment that was diagnosed and planned. This is the exact moment where trust either gets reinforced or quietly starts to fall apart.

If the person sitting next to them is not confident, unclear, or does not fully understand the “why” behind the recommendation, patients feel that instantly. Not because they are trying to challenge us (well, sometimes they are), but because they are trying to make sense of something that matters to them that is often coming at them in a foreign language. 

As we are evaluating the role of assistants and hygienists, it would be a mistake to limit their scope and the expectation of what they can deliver. They should be educators and translators. In many cases, they are the final voice the patient trusts before making a decision, and that requires more than surface-level knowledge. It requires the ability to meet the patient where they are because our patients’ dental IQ can vary widely.  

Sometimes it will be a healthcare professional sitting in the chair who wants details. Sometimes it will be a teenager that just wants to get back to their phone as soon as possible and a simple explanation will suffice. In any scenario, the eyes of the team member should not dart away because they do not know how to explain a procedure, rather, they should be fully prepared and competent to answer. 

This culture of expectation should not stop at the doorway back into the front of the office but should carry through to the team in the front. 

When a patient sits down to review a treatment plan, they are not just hearing numbers. They are deciding whether they trust what just happened in the back. If the clinician walking them through that plan does not believe in it, if there is hesitation when explaining the “why,” or discomfort when discussing the cost, patients feel that immediately. 

The same applies to financial options. If we present fees like we are apologizing for them, or avoid the value conversation, we create doubt where there should not be any. When the entire team is aligned—when the front believes in the diagnosis, understands the impact, and can clearly explain it—that conversation changes. 

The year is still early; we have an opportunity to work on a self-evaluation this month that may confirm what we already know or show us that change is needed before we can rise to the level of success we’re striving for. What are our eyes telling everyone around us? 

Have a happy and productive April everyone! 

Andrew Johnston, Editor in Chief of DentistryIQ