It must be one of those situations when dentists feel the most unloved: that moment when you are explaining to a patient who came in for a routine check-up that they need significant dental work.
They didn't feel anything wrong, and they didn't see anything wrong (although it may be something that they see every day, to the point where it has become “invisible” to them) and now here you are proposing hundreds or thousands of dollars worth of treatment. Nobody likes unpleasant surprises, especially surprises that come with unexpected expenses, so it's hard to blame them for being upset.
The hard truth is, the blame for this scenario (at least in part) can often be attributed to the way dentists and dental professionals have been talking to patients for years. I'm talking about the “prevention mindset” that gets drilled into patients: Brush and floss every day, keep up to date with your hygiene visits, and you will enjoy great dental health. Naturally, for someone who follows these “rules” it feels almost like a betrayal to then be told that those measures were not enough to immunize them from the need for more advanced care.
You know that eventually almost everyone needs treatment that goes beyond hygiene and simple maintenance—that's just the reality. It's a reality you can't change, but you can help to avoid those shocking surprises by preparing patients for that reality.
So you need to take the conversation to a higher level. By all means, continue to stress the importance of good oral health maintenance. But don't leave it at that. If you want to avoid the situations where patients feel blindsided—or where they start requesting “just a cleaning” because they are afraid of what you will find—you need to have a conversation about the value of lifelong care and how greater clinical intervention will at some point probably be necessary.
I have found that a good way to have that conversation is by way of a simple appeal to common sense. We all know at some level that our mouths are the gateway to so many things that make our lives complete. You use your mouth to talk, to smile, to eat and drink, to kiss. And yet we often take it for granted. And patients need to realize that conditions will change over time—in the mouth and in dentistry. They will develop conditions that require attention and you will develop new ways of treating them. That's why the hygiene visit is so important—it's not just for getting a “cleaning”—it's about getting a regular clinical review of that condition.
To help you establish the right context for this conversation, I suggest reviewing this online team meeting video course, where I provide more insight on the topic and even give a sample analogy you can use to make the point to your patients in a powerful way.
I truly believe that this is a conversation worth practicing, because it is an important conversation to have with patients, and it's important to have it as early in the relationship as possible. It's the conversation that you must have today to help take the sting out of those inevitable conversations you will have to have down the road.