DTUS2010

Do you have general comments or criti- cism you would like to share? Is there a particular topic you would like to see articles about in Hygiene Tribune? Let us know by e-mailing feedback@dental- tribune.com. We look forward to hearing from you! If you would like to make any change to your subscription (name, address or to opt out) please send us an e-mail at database@dental-tribune.com and be sure to include which publication you are referring to. Also, please note that sub- scription changes can take up to 6 weeks to process. Tell us what you think! HYGIENE TRIBUNE The World’s Dental Hygiene Newspaper · U. S. Edition Publisher & Chairman Torsten Oemus t.oemus@dental-tribune.com Vice President Global Sales Peter Witteczek p.witeczek@dental-tribune.com Chief Operating Officer Eric Seid e.seid@dental-tribune.com Group Editor & Designer Robin Goodman r.goodman@dental-tribune.com Editor in Chief Hygiene Tribune Angie Stone, RDH, BS a.stone@dental-tribune.com Managing Editor/Designer Implant, Endo & Lab Tribunes Sierra Rendon s.rendon@dental-tribune.com Managing Editor/Designer Ortho Tribune & Show Dailies Kristine Colker k.colker@dental-tribune.com Online Editor Fred Michmershuizen f.michmershuizen@dental-tribune. com Account Manager Mark Eisen m.eisen@dental-tribune.com Marketing Manager Anna Wlodarczyk a.wlodarczyk@dental-tribune.com Sales & Marketing Assistant Lorrie Young l.young@dental-tribune.com C.E. Manager Julia E. Wehkamp j.wehkamp@dental-tribune.com Dental Tribune America, LLC 213 West 35th Street, Suite 801 New York, NY 10001 Tel.: (212) 244-7181 Fax: (212) 244-7185 Published by Dental Tribune America © 2010 Dental Tribune America, LLC All rights reserved. Hygiene Tribune strives to maintain utmost accuracy in its news and clinical reports. If you find a factual error or content that requires clarification, please contact Group Editor Robin Goodman at r.goodman@dental-tribune.com. Hygiene Tribune cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Dental Tribune America. Anyone with any training in deal- ing with the public has heard the saying, “The customer is always right.” But does that hold true in the dental office? Every dental professional will recognize this scenario. The patient comes in and tells the clinician what they do want, or more oftentimes, what they do not want done. The request might sound something like, “I know I haven’t been in for a cleaning in a really long time, but I don’t want any X-rays taken today because I can’t afford them.” Then the patient continues with comments such as: “Don’t spray any water in my mouth,” “my teeth are sensitive to cold so don’t scrape at them,” and “don’t polish my teeth, the paste is too gritty.” How is the clinician supposed to respond to patients such as these? There are two ways to approach this situation. One is for the dental professional to make a case for what “needs” to be done. This begins with the clinician making a case for the necessity for X-rays, water, scrap- ing and polishing. This is followed by the patient reiterating that he may result in a happy patient who is willing to return and a clinician who feels fulfilled because she was able to work with this patient and make progress. As with all things, there are pros and cons to each scenario. Because there is no clear-cut answer to this predicament, the office needs to have a policy in place about how it will handle such patients. Is the office going to stand firm in its treat- ment procedures or is the office going to work with patients who present with these challenges? Once the policy is put into motion, team members know what is expected of them and they are to act accordingly. This will certainly cut down on the drama and com- plaining these types of patients usu- ally cultivate in the office. Best Regards, Angie Stone, RDH, BS Editor in Chief doesn’t want any of those things done in a slightly louder and firmer voice. At this point, the struggle has begun. This scenario will usually end up with one of the individuals being upset over the turn of events, and can even lead to the loss of a patient. Worse, yet, it can lead the patient sharing a less-than-glowing opinion of your practice to other potential patients. The result of this approach may be lose-lose for all parties involved. What would happen if the cli- nician would say, “OK” when the patient lays down the ground rules? There is a camp that would say, “Give the customer what they want and keep them happy.” If the patient is happy, would it not be a more enjoyable appointment for all involved? Taking baby steps to get this patient educated may be the best way to approach this dilemma. The focus here is on making the appointment pleasant enough to get the patient to come back for future appointments so progress can be made toward better oral health. This approach The customer is always right? away the extra. Hey, you’re really good at this, Tyler. Look, Mommy’s proud of you. Stay put, we’re going to do the other side next.” Dealing with parents As we all know, parents can help or hinder. The AAPD points out that with modern parenting styles, children may be ill-equipped with the coping skills and self-discipline necessary to deal with new experi- ences such as a dental visit.1 Sometimes it helps to ask the parent to let you do the talking. “Tyler can only listen to one person at a time, and right now that needs to be me.” This establishes you (with both parent and child) as the person in control. Another technique is to make the parent’s presence contingent on good behavior. “Tyler, if you can be a good boy and sit quietly, without fussing, Mommy can stay here and watch. If you’re going to fuss, she’ll have to wait for you out front. Which do you want her to do, stay or go?” Pediatric behavior management can work well if you begin carefully. Establish a comfortable, caring relationship; exhaustively describe everything that will happen before it happens; and be firm, calm and authoritative about the behavior you expect. HT References 1. www.aapd.org/media/policies_ guidelines/g_behavguide.pdf; accessed Aug. 25, 2010. 2. Farhat-McHalyeh N, Harfouche A, Souaid, J. Can Dent Assoc, May 2009, 75(4):283a–f. f HT page 1B Editor’s Letter HYGIENE TRIBUNE | September 20102B verbal praise and appropriate physi- cal demonstrations of affection. • Distraction: Diverting the patient’s attention from what may be perceived as an unpleasant pro- cedure. Giving the patient a short break can be effective.1 We can also add live modeling, which a recent study found to be more effective than tell-show-do. Live modeling in which the child’s mother underwent treatment first resulted in lower heart rates for chil- dren than either live modeling with the father or tell-show-do.2 Customizing these techniques, along with keeping up a constant stream of information and never letting anything be a surprise, are the best ways I’ve found for dealing successfully with anxious children. For example: “Tyler, take a look at my special brush. See how it goes around in a circle? Let’s touch your finger. Is it buzzy and tickly? That’s how it’ll feel on your teeth. I’ll start right here on the side, so you’ll know how it works. Is it tickly? Don’t laugh too hard. “Here’s my water squirter, remember? Here comes the water, and here comes the straw to suck About the author Cathy Hes- ter Seckman is a dental h y g i e n i s t , speaker, writ- er and index- er. She is a 1974 graduate of West Lib- erty State Col- lege. As a hygienist, she has been in gen- eral and specialty practices for 29 years, including three years as a temporary hygienist. Since 2003, she has worked in a pedi- atric practice. For the past four years, she has presented continuing edu- cation programs for hygienists on pediatric management, nutri- tion, communication and pre- natal to pre-school care. She has published nearly 100 articles in dental magazines. ‘With modern parenting styles, children may be ill-equipped with the coping skills and self-discipline necessary to deal with new experiences such as a dental visit.’

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