It's the common request of patients (and prospective patients) who don't value dentistry highly: I only want a cleaning.

I've spoken many times about how you need to build a bridge with this patient to get them to see dentistry – and their oral health – in a new light, and that's an ongoing process. But what exactly do you say when they make this request?

First of all, it helps to know a bit about why they only want a cleaning. This is where some early intelligence gathering can really pay off. Are they a visiting “snowbird” that has a regular dentist back home? Maybe there's a wedding or reunion coming up and that's prompting them to make a rare visit to the dentist. Maybe they're saying it because they know they have an issue that they don't want you to remind them about – or they suspect you'll find an issue they don't want to hear about.

Or it could just be that they have been hearing for years that brushing and flossing and regular six-month preventive visits is all it takes to keep their mouth healthy, so that's all they're going to ask for.

Naturally, the more you can find out about their motivations, the more you can tailor your discussions to appeal to their needs. But whatever you end up learning, your response to their request should cover three steps:

  1. Validate and encourage. It helps to start on a point of agreement and you want to acknowledge them for seeking this care: “I'm so glad you want to take care of your teeth and smile, and hygiene care is so important.”
  2. Set context. They need to know what hygiene does and does not do: “Hygiene is a clinical service that provides care beyond what brushing and flossing can do. It also helps prevent new disease and concerns from developing. But it will not correct concerns that have already started since you last saw a dentist.”
  3. Create value for awareness. Emphasize that you just want them to know about their condition: “Because our doctor is so thorough, he feels strongly that patients like you must have an exam before hygiene so you can know the current state of your teeth and mouth, even if you just go forward with hygiene.”

If it's applicable, you can also reinforce that last message with a statement such as, “It is also a requirement in this state that patients must see the doctor before hygiene.”

In the end it's up to you to decide if you will accept patients into hygiene without a commitment to a full exam (some dentists do, on the assumption that they can move the patient in that direction later). And these example responses are not intended to be scripts for memorizing.

Discuss among the team what your policies are and brainstorm the best language to use. The point is you will continue to get this request on a regular basis. You should be prepared for how to deal with it.