How to handle the patient who hates you

Let’s face it – most people do not look forward to a trip to the dentist. While shadowing as a predental, I specifically remember a patient greeting the doctor with, “No offense, but I hate you.” Understandably so. We invade our patients’ personal space, we put instruments in their facial orifices that resemble torture devices, and some of our patients honestly have no idea what we look like under our 20 layers of PPE. It is our responsibility to ensure anxious or fearful patients have the best possible experience during their visits with the hopes that we can make the difference in overcoming their dental phobias. Here are few tips for when you inevitably encounter the patient who hates the dentist.

Be honest: If you are administering a palatal injection, it is not going to feel great. Tell them, “this may pinch a little.” Never promise that something will not hurt. Lying to your patients by promising to eliminate any discomfort from their experience is a quick way to lose their trust. Everyone has a different threshold for pain and discomfort, making it impossible to guarantee a totally painless experience no matter how conscious you are of your patient’s comfort level. Instead, put them in control. Tell them to raise their hand if they feel any pain and you will stop. This places them in the driver’s seat of the appointment.
Talk through the procedure: Humans have a natural desire for prediction. We fear the unknown. Often, the anticipation or preliminary fear is worse than the event itself. Explaining procedures to your patients will help them understand what is going on in their mouth. Think about it: from your point of view, you can see everything through your 2X loupes, mirrors and retraction devices. Your patient cannot feel anything, cannot see anything and is left to trust you with whatever is happening in their mouth. It is a good idea to give a brief overview of the appointment before getting started and even take a few moments throughout the procedure to explain what is going on, making a point to emphasize the positive aspects of the appointment.
Intervene early: Fear is often a learned behavior. If you are seeing a fearful parent with young children, encourage that patient to bring in their children once their first primary tooth erupts to develop a positive relationship with the dentist. Educating parents early on the importance of oral health is the most effective way to establish good oral hygiene habits, which will ultimately help prevent the need for invasive dental procedures in the future. Thus, trips to the dentist will involve less drilling and filling and more praise for the patient’s good oral hygiene, which helps take the “scary” factor out of a dental visit.
Get to the “root” of their fear: It is crucial to find out exactly where a patient’s fear originates. Common dental fears are from a past painful dental procedure, visiting a dentist with poor bedside manner, or having a negative experience involving financing their dental work. Talking through their fears will enable you to empathize with whatever is making them uncomfortable and allow you to avoid creating the same detrimental scenario again.
Create a relaxing work space: Aromatherapy is a natural trend that practitioners are using to soothe anxious patients in high-stress situations. Essential oils such as lavender and chamomile have calming properties. Decorating your office with a relaxing color scheme, such as light pastels, will make your work space more welcoming and feel less hospital-esque. The use of technology (televisions, music and gaming systems) to psychologically divert your patient’s attention to something other than the drill buzzing in their ear will enable them to detach from the procedure taking place. If you really want to get fancy, massage chairs are a nice touch.
Establish a presence in the community: Establishing yourself as a trustworthy member of society is crucial to developing a positive reputation. Giving back through volunteering or sponsoring events will demonstrate your desire to promote the well-being of the community you and your patients call home. Being an active citizen will allow you to network outside of the office as well as develop rapport with your clientele on a more personal level, thus establishing a sense of trust. It is essential to get people to trust you in order for them to trust what you are doing. By being approachable, you will attract patients in your community that will trust you with their care before they even set foot inside your office. This is an excellent way for anxious patients to meet the person behind the mask in a more comfortable, stress-free environment.