Content Dam Diq Online Articles 2017 05 Bad Breath 1

Troubleshooter: What to tell dental patients who refuse to brush

Oct. 20, 2022
Most dental professionals encounter patients who are "too busy" to brush their teeth. See what three dental pros have to say about managing this situation.

QUESTION: I work in an office where the clients say that they are so busy and stressed with their jobs that they simply do not have the energy to brush their teeth. Their mouths are a mess. How can I motivate them to see a difference?

Unfortunately this is something that dental professionals hear all too often. I’ve heard it from stay-at-home moms to single professional men who tell me they have no time to brush. One single male patient of mine only brushed on the weekend when he went downtown with friends to try to meet women. No wonder he was single, we joked at the office.

With him and others I simply say, "Well, do you have time to shower? Then take your toothbrush into the shower with you. It’s easy." I will compare not brushing to not cleaning oneself properly after going to the restroom. Does someone skip wiping for lack of time? This also tends to grab their attention. For the stay-at-home mothers, I tell them to brush with their kids, to be an example in order to teach their kids proper hygiene skills. Cleaning ourselves is necessary to keep bacteria levels down and to prevent infection.

Also, bringing up the bad breath issue usually helps. No one wants bad breath, which can prevent a person from having friends and close relationships. So, brushing not only cleans the crud off teeth but always keeps breath fresh. So, I would recommend to patients to scratch their teeth and look under their fingernails. If plaque is present, then they need to smell it. Tell them that this is what their whole mouth smells like to others. If their gums are bleeding, then there is also infection along with the bad odor.

ANSWER FROM KAREN DAVIS, RDH, Cutting Edge Concepts:
Every dental hygienist on the planet has struggled to find the magic words to motivate patients who are very unmotivated, so your question is a pertinent one. For patients who are unmotivated to take ownership of their oral health, I simply pose a challenge to them. I ask them if they would agree to do one thing differently only once a week between today’s visit and their next visit. I preface it with, “It’s incredibly easy.”

Maybe it’s just out of curiously, but so far 100% of my patients have agreed to the challenge. I ask them if they shower daily. Most say yes. I ask them to brush with Plaque HD toothpaste on Sundays while in the shower, and when they dry off, to look in the mirror. If they see green, they need to keep brushing until they see no green. (This is not a difficult thing to do as no one is willing to leave the house with green teeth.)

This toothpaste is a brilliant motivator because it has a plaque-disclosing dye in the paste, so ineffective brushing is impossible to miss. I have found that when asking them to do this once a week, most become curious and end up using it more than once a week to see how they are “progressing.”

Patients can order Plaque HD toothpaste online, but it will be easier if you order it and dispense it directly from your office so they can leave the office with it in hand. Be sure to go to the Plaque HD professional page to read the article published in 2016 in the American Journal of Medicine about Plaque HD toothpaste lowering systemic inflammation.

I believe that determining how to motivate people is one of the most difficult challenges faced by dental professionals. Motivating children is different from motivating teens, and teen motivation is different from adults. Even among age groups there are variations in personalities, so segmenting by age is not always productive.

I believe the key to motivation is to find a connection with the patient. Connections are discovered through conversation. If I discover my patient likes chocolate ice cream, then I can say, “Wow, that’s my favorite too!” We have something in common. Another thing I know is that when patients like us, they are more amenable to our treatment suggestions. So it’s up to us to set a friendly tone and make patients glad they visited the office.

The old cliché that you attract more flies with honey than with vinegar is true! Unfortunately, fussing over patients' lack of home care can make it seem to them that we don’t like them. They take it personally when we use “you” statements such as, “You’re not brushing well.” When we focus on a particular behavior rather than the person, we will see more success. For example, “It looks like this area needs more attention,” is preferable to “You are missing this area.”

The other part is the realization that some people cannot be motivated, no matter what you say or do. So just accept this and you’ll rest a lot better.


How to handle "that" dental staff person (think Debbie Downer)
How to shush dental patients who have too many questions
What to do about poorly dressed dental team

Do YOU have a tough issue in your dental office that you would like addressed? Send your questions to [email protected] for the experts to answer. All inquiries will be answered anonymously.

Originally published in 2017 and updated in 2022.

About the Author

Team Troubleshooter

This weekly column on DentistryIQ features questions from everyday people who work in dental practices, who have issues they would like addressed by the experts. Those who regularly take the time to answer questions include Rebecca Boartfield, Patti DiGangi, Dr. Chris Salierno, Laura Hatch, Karen Daw, Jill Townsend, Lisa Marie Spradley, Shelley Renee, Judy Kay Mausolf, Robin Morrison, Paul Edwards ... and the list is growing.

Send your question or issue for an expert to address to [email protected].. You'll be glad you did.