If your bone were melting away, would you want to be told?

by JoAn Majors

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What happens when you say to a patient that she has "a little resorption" (or "a little bone loss") versus telling her that her "bone is melting away"? In the patient's mind, there's a world of difference.

The American Heritage Dictionary defines resorption as "the destruction, disappearance or dissolution of tissue or body part by biochemical activity, as the loss of bone or of tooth dentin." These words indeed sound scary and suggest hurricane-level damage in the patient's mouth, but to someone who may never have heard the definition before, resorption sounds like absorb again, like everything goes back to normal.

We know that just the opposite occurs: A patient loses 4 mm of bone within the first year of losing a tooth. That's 10 times greater than the rate in the following years.

Consider this: If your bone were melting away, would you want to be told? If instead of postponing treatment, you could save time and money for a problem that only gets worse the longer you wait, wouldn't you want to be told of its urgency in language you could easily comprehend?

After all, you're captive in the dentist's care and know nothing of dentistry but how you feel when you're in the treatment room. If something that could be taken care of now actually costs less, isn't it the doctor's responsibility to tell you? If the doctor ends up profiting from your failure to act promptly, his or her professionalism could very well come into question.

Did the dentist gain at your expense by withholding information about your health? Would the dentist be guilty of supervised neglect, afraid that you would like him or her less, or of diagnosing your pocketbook instead of your mouth?

Since words – both their explicit meaning and their inferences – are the door to whether or not you're allowed to perform the service, why not own the language? Imagine that a patient decides a year after losing a molar to agree to your recommendation for a single tooth implant. If you hadn't told him before about the possibility that he will first have to consider bone grafting, telling him now can seem inappropriate or a downright hustle. Get permission ahead of time to disclose the total story.

"Mr. Patient, may I have your permission to share with you everything that concerns me?" What do you think your patient is going to say ... "No"? The best thing about getting permission is that it liberates you from your own erroneous zone of timidity.

When we fear, assume, or anticipate rejection, we often start editing our content in the hopes of not offending. Especially when communicating your patients' oral health, this is an error of judgment.

Eliminate insider "shop talk" and include your patients in the conversation. You know what the words mean, but your patients don't, and that means they're left out. Since that's not your intention, take the opportunity to include them. Translate every scientific, multisyllabic phrase into savvy lingo that any layperson can understand.

In addition, eliminate the use of limiting terms. When talking with patients, reverse the industry-wide tendency to make the treatment sound bad and the disease sound good. Instead of apologizing to them for their condition, make the treatment sound like an easy, wise, economic, and long-term solution, and make the disease sound like what it is, an illness that gets worse by doing nothing. That's only fair to your patients. After all, they have the condition, not you.

In fully leveling with your patient, forget about we, as in, "We have a little infection here," and forget little. Your patient is thinking, "If we have the infection and it's little, you get the treatment … I'm going fishing!"

Limiting terms are for shrinking violets, not health professionals. Patients appreciate candor and language they can understand. Their diseased condition only illustrates their need to become better informed. So replace each phrase you use with a word picture that causes patients to see their condition clearly, in their own language, and in a way that underlines their need for urgency.

If you want your patients to make the wisest decisions for their dental health, speak to them in language that causes them to do so instead of language that makes them feel stupid or unseen. Your case presentation success rate will increase in proportion to your patients' comprehension of their condition.

JoAn Majors is a registered dental assistant, published author, and professional speaker. In addition to speaking, she leads the Team Training for the Misch International Implant Institute. For more on her seminars and latest book, "EncourageMentors: Sixteen Attitude Steps for Building Your Business, Family and Future," visit www.joanmajors.com.