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De-stress your patients & your practice

Oct. 1, 2003
Stressed-out patients cause stress in your practice. But you can combat patient stress using all five senses.

by Dixie Gillaspie

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Our patients lead busy, demanding lives, many arriving at the dental office breathless, exhausted, and stressed. And a stressed-out patient causes stress in the practice. They are harder to numb, less likely to accept treatment recommendations, and more likely to resent paying the fees. They cancel or fail to show up for appointments because they just can't deal with the added stress of a dental visit. Stressed-out patients are hypersensitive, tense, and quick to interpret everything they see and hear in the worst possible way. In fact, many of your least favorite patients may simply be highly stressed.

Do you know what causes patients to be stressed-out in your office? Well, sure. The shot causes them stress. You might diagnose something that causes them stress. Paying the bill causes them stress. It seems like everything you do causes them stress. There just isn't anything you can do about it, right? Sure there is!

While it's true that all of those factors can increase stress, those aren't the things that really irritate your patients. The more stressed-out patients are, the more strongly they will react to the shot, their treatment needs, and the bill, but it's the little things in your office that can either soothe or exacerbate the problem, especially in patients who are stressed when they arrive.

If your patients are already stressed when they walk in to your office, then everything they experience while they are there will either relieve that stress or aggravate it. Think in terms of a scoreboard: If patients get exactly what they expect, their stress level stays the same. Every irritant increases their stress and every unexpected pleasure decreases it. The lower the stress level, the more positively patients will respond to their dental experience, which means you both win!

Here is a list of top stress builders and stress soothers compiled from visits with dental patients across the country. Just for fun, we divided them according to the five senses.

Stressed on sight

• Clutter or a lack of cleanliness — Clutter causes patients to wonder how organized their care will be and how clean your treatment rooms and instruments really are.

• Barriers between you and the patient — "The Window" ranks as the most hated barrier. Patients say they feel that a closed front-desk window is just there to keep them from bothering the staff. Gloves and masks outside the treatment room are also rated as cold and unapproachable, with some people commenting that they can't help wondering if those gloves are clean.

• Outdated or worn-out décor — A shabby environment gets comments like, "I guess he doesn't care enough about his office to spend money on it," and "I'll bet if he had to sit out here, he'd make it nicer."

Soothed on sight

• Fresh flowers — Believe it or not, everyone said flowers make them smile. Small arrangements or plants are considered a nice touch, but practices that offer a rose or carnation after an appointment get top marks.

• Unusual magazines or coffee-table books — No one wants to see the same magazines they just read while waiting to get a haircut. Picture books and cookbooks are mentioned as being the "neatest."

• Fish tanks or serenity fountains — The sound of water is soothing; it's hardwired into our psyche. Watching fish leisurely floating in a crystal-clean tank projects a peaceful image.

Sounds that stress

• The high-speed handpiece — Those of us who spend our lives in dental offices aren't even aware of the noise, but patients say they get tense every time they hear that whine. Use background noise to soothe and distract, and consider segregating hygiene treatment rooms from the restorative area so that hygiene patients aren't as exposed to handpiece noise.

• Overheard conversation or loud, excessive laughter — Especially irritating when left alone and waiting, hearing the staff talking and laughing loudly makes most patients feel left out and uncared-for.

• Unhappy or sharp voices — People are extremely sensitive to voice tones, even when they cannot understand what is being said. If the conversation they overhear between team members, on the television, or even between other patients is anxious, accusing, abrupt, or fearful, they will begin to take on that emotion. The fact that they cannot hear what is being said and, therefore, have no context for the emotion, actually makes it worse.

• Loud music or other noises — This includes televisions, street noise, crying children, or anything edgy or startling.

• Being left on hold with no sound — Silence on hold makes the time really drag, but a scratchy, fading radio signal may be even worse.

Sounds that soothe

• Personal headphones — Soothing music gets good marks, but personal headphones get rave reviews. Even headphones with just a built-in AM/FM radio are popular, but a personal CD player is considered the favorite because patients can bring their own music choices with them.

• Music or messages on hold — Music is very popular if it's clear and upbeat. A message on hold is well-received if the message is informative and interesting rather than preachy.

Touched by stress

• Temperature — A nearly universal complaint is "It's freezing in there!" The body temperature of a tense, stationary patient is considerably lower than that of gloved, masked, moving doctors and staff. Older patients especially complain of being too cold to relax in the dental chair.

• Dry, chapped lips — Long dental procedures often result in dehydrated lips that feel dry and chapped. t Dental chairs — Patients complain of sore, tense shoulders and necks.

Soothed by touch

• Pillows and blankets — As much of a hassle as most practices find them, neck pillows and light blankets add a lot of physical and psychological comfort to a dental appointment.

• Warm, moist towels — At last, a nifty machine called ComfortSpa, which we saw exhibited at the ADA, makes providing warm towels a cinch.

• Lip balm — Several companies — Blistex is one — make single-use packets of lip balm that can be offered following a procedure.

Smells that stress

• That dental office smell — Most patients can't define it, but they say it makes their skin crawl. What we don't necessarily want them to know is that smell is what happens when you put bur to tooth and the tooth gets hot.

Essentially, it is the smell of burning human bone, and it kicks off a fight-or-flight response. Anything you can do to reduce or mask this smell will be well-received.

Again, consider segregating your hygiene rooms so that those patients are away from the restorative area.

Soothing smells

• Food scents — A big pleasure for most of us, the smells of coffee, warm cookies, lemon, vanilla, and almonds are associated with comfort.

• Aromatherapy scents — Use air diffusers or candles or keep the fresh coffee and cookies coming.

Tasteless stressers

• The shot — The taste of anesthetic is never pleasant, and since most patients rate the shot as their least favorite part of a dental visit, why make it worse? Rinse immediately and suction well. The same is true of impression materials.

• Grit — Leaving the office with teeth that are still gritty with prophy paste may not seem like a big thing, but patients just can't wait to really rinse their mouth.

Tasteful soothers

• Mouthwash — Allowing the patient to rinse with a small amount of mouthwash overrides any lingering unpleasant tastes and helps make the patient feel less dehydrated. Consider using a product like Oxyfresh or Tooth and Gum Tonic to aide in healing and controlling bad breath.

• Mints or gum — We love Biotene mints and gum because their products are formulated to combat a dry mouth, but any mint flavor is appreciated.

OK, you're now ready to combat patient stress using all five senses. Get started today and see how much you can reduce the stress in your practice.

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