Did you know that “more than one-third of Americans (36%) would rather do an unpleasant activity like cleaning the toilet (14%) over daily flossing”?1 As unreal as this may seem, we know those patients exist. Educating patients about a consistent home-care routine is crucial, and each recommended routine should cater to their specific needs. There are numerous tips, tricks, and tools that may enhance patient compliance, but the paramount adjunct may be actively listening to your patients to determine your recommendations.
It's how you say it
There is proven success in setting realistic home-care expectations for your patient. It’s not just what you are suggesting but how you suggest it. Emotions are a vital element. Simply saying, “Make sure you brush twice a day for two minutes, get some flossing in there, and use Listerine” isn’t going to resonate with most individuals.
Speak with intention to each person sitting in your chair and continually be conscious of your audience. Having a dialogue with your patient that is empathetic allows for increased patient understanding. Is your patient a plaque-covered preteen? Focus on brushing. Let them know how stinky their breath could get, show them the thick plaque you’re removing, and create desire to make a change.
Is your patient a busy mom with a baby on her lap as you perform your prophy? Remind her that bacteria in her mouth can be transferred to her baby and to use floss picks while she showers. Is your patient a stubborn older gentleman who has lived a long life without using mouth rinse? Recommend he increase water consumption. These suggestions may not be perfect but they will be realistic. We might always want to personalize our home-care suggestions, but communicating what is most beneficial for our patients’ oral health is always our top priority.
You might also be interested in: Dear Patient: 6 ways to up your home care game
If a patient isn’t currently flossing, then requesting daily flossing may not be reasonable. Instead, recommend that the patient floss Mondays, Wednesdays, and Fridays, at least three times a week. Let them know they have options: string flossing, floss picks, or water flossing. After discussing which adjunct is best, provide instruction for use. If the water flosser is selected, provide the patient with names of water flossers they can purchase.
Make suggestions for toothbrushes, toothpastes, interproximal adjuncts, and mouth rinses. Provide the patient with a sample if possible; if not, write the suggested item on a sticky note or the recall card. Several patients keep their phone in hand during appointments; suggest they do a quick Google search of the power toothbrush you recommend. These small gestures will create emphasis and resonate well with the patient. Find the focus for your patient and create a realistic, tangible, and measurable home-care routine.
Acknowledge that you know they're trying (and so are you)
Remind the patient that you’re providing an optimal professional cleaning and the expectation is to discover less plaque, less calculus, or less bleeding at the next recall appointment. Utilizing an intraoral camera to provide before-and-after images is a great way to set the standard of expectations. At consecutive appointments, have discussions about the prior recommendations and give praise for even small successes. A personalized message to each patient will leave them feeling empowered to improve their own self-care.
Reference
1. American Academy of Periodontology. More than a quarter of U.S. adults are dishonest with dentists about how often they floss their teeth. Perio.org website. https://www.perio.org/consumer/quarter-of-adults-dishonest-with-dentists. June 23, 2015. Accessed November 8, 2018.
Editor's note: Originally posted in 2018 and updated regularly
