When patients open their mouths wide, do not insert your foot into yours

By Amy Nieves

A few weeks ago, my oldest daughter came home from work visibly upset. She went to her room immediately and slammed the door. I knocked on the door and asked what was wrong. With tears in her eyes, she explained that co-workers were speaking of people of Spanish descent in derogatory terms. I was shocked and angry, to say the least, that this still happens today. While I am not Spanish, my husband is of Spanish descent. It hurts to hear people stereotype others, because they may be talking about family or loved ones. It is a form of discrimination.

I grew up in New Jersey. Some may say that people from the Northeast are rude. My experiences in the Northeast have been much different. I grew up in areas with a great variety of cultural backgrounds. My friends were of different religions, different ethnical backgrounds, spoke different languages at home, and had parents with different political affiliations. These experiences were not only valuable, but also life-changing. My family taught us not to judge people for their backgrounds or supposed stereotypes. Respect people for their differences.

We all have rights to our own opinions or beliefs, but as health-care practitioners, we need to be sensitive to those of our patients. As dental hygienists, we have the ability to get to know our patients when we see them on three-, four-, or six-month intervals from 40 to 60 minutes at a time. Please be careful about statements you make to your patients. A mention about religion or a certain cultural background may not be intended to be offensive, but patients may become offended. Do not assume that every patient shares your same beliefs. We may alienate certain patients with innocent statements.

I was present when a doctor was referring a patient to an endodontist. The doctor proceeded to tell the patient that this office was a good, Christian office. The doctor explained to the patient that he refers only to Christian offices because of the values. The problem was, this patient was Jewish. The doctor did not know this and assumed she was Christian. Highly offended by the suggestion that only Christian offices have good values, she complained that she would not be returning to our office. This innocent comment offended me, too, because I have family members who are Jewish.

Another example was hearing a staff member putting down people of a particular political party. This staff member expressed her frustrations with mentions of stereotypes. Although a good person, this staff member neglected to think that her patient might have different opinions and beliefs. Without realizing it, she had offended this patient. It is not our place to engage in political or religious debates while we are providing dental care to patients.

There is vast cultural diversity in this country. It is important to respect these cultures. All health-care professionals need to learn communication skills and be sensitive to other cultural beliefs. Toni Adams, RDH, BS, speaks on communication studies. She states on her Web site (www.toniadams.com):

"Though the melting pot metaphor is passé, the United States has been variously referred to as a cultural stew, salad bowl, tapestry, quilt, and mosaic. No matter how it is put, we are and always have been a diverse nation. Heterogeneity is our heritage, but such cultural diversity creates communication challenges. This is certainly true in the delivery of health care where miscommunication can impact quality of life and even literally make the difference between life and death. These issues are especially relevant today when knowledge about the relationships between oral and general health continues to expand."

Cultural communication skills ought to be included in health-care educational programs and continuing-education courses. As health-care providers, we have the opportunity to educate our patients on oral and general health. Dental professionals should not engage in conversations that might offend these patients. Good intentions to make small talk may actually end up alienating patients.

Amy M. Nieves, RDH welcomes all dental hygienists to join her online hygiene community by going to www.amysrdhlist.com. Hygiene resources can be found at www.amyrdh.com, including comprehensive resources for students to study for national boards. Amy has co-written a book with Shirley Gutkowski, RDH, BSDH, called The Purple Guide: Developing Your Clinical Dental Hygiene Career, which can be purchased at www.rdhpurpleguide.com. Amy practices four days a week in a periodontal practice in Longwood, Fla. She welcomes correspondence by e-mail at [email protected].