Seven: As You Move Through Treatment
Dental World Second Supplement
Pre-Scaling Permission Ritual and Name Change
Ask for permission to use the Cavitron. In keeping with plain language, inform the patient that you will be using a “water pick” that sprays a lot of water and makes some noise.
This introduces the tool that will be used using a harmless name. Ask if they have any teeth sensitive to cold.
These two touches start the important process of explaining and containing the sounds and sensations they will experience in a nonthreatening context, and help with the smooth transition into scaling.
Labelling Sensations: “Sensitivity”
Let the patient know that you will start on the lower front teeth very slowly to get them used to the noise and vibration.
Explain that you’re starting here because it tends to be the most sensitive area.
Letting them know that these are the most sensitive teeth does a couple of things. First, the patient understands that they should expect to feel something, and that it won’t be anything they can’t handle. Second, sensitivity isn’t something to worry about. It’s not related to damage as “pain” often is. So they will mentally label this sensation as safe, and will be calm for as long as the scaling stays below this level of intensity.
“Sensitivity” is an important word and concept to give your patients to describe their sensations.
It’s also a gentler word for them to use in talking to you. Where they might politely hesitate to say something “hurts,” which might feel like an accusation or a complaint, a patient is has no reason not to speak up about sensitivity.
Check-in Banter
As you scale, ask whether the water temperature and the vibration is still tolerable. These terms are useful for the same reason “sensitivity” is: gentler words for them to use, and small things they will feel comfortable expressing a preference about. The more comfortable they are expressing themselves, the more comfortable they will be.
Stop frequently during scaling to remove excess water. Use it as a chance to say something encouraging and orienting before you start back up, too: “Everything is coming clean very nicely. I only have the top right teeth left. Ready?”
As they can swallow, speak, and breathe more comfortably, they remain near their baseline comfort. These frequent breaks also keep a more normal communication style going, since they know they will have regular chances to speak with you.
Scraping
With hand scalers, there are some very nasty sounds and sensations. Make the effort to let the patient know that it sounds worse than it is. Humor helps. You can throw out all of the trust you’ve built up if you’re not thinking about how hand scaling sounds and feels to the patient. Don’t let their imagination run wild.
Flossing Education
As you floss the patient and educate them on proper flossing technique, don’t focus on how people don’t do it enough. Empower them. Introduce information that helps them improve their habits: Let them know times and ways to fit it into their day—have they tried flossing while watching their shows? Many people want to do a better job on their hygiene. It’s a matter of connecting to how they understand their hygiene needs now and helping relate that to what else or what more they can do.
Polishing
Prior to coronal polishing, offer different polishing paste flavors to give them a second to sit and breathe normally after the scaling. Explain why you polish the teeth. It’s informative, signals that the hard part is over, and it gives them more time to rest.
Let patient know polishing might “tickle the gums,” so they are not caught off guard. Be gentle when polishing. Remember: speed, pressure, and paste grit can create heat and sensitivity, especially after scaling.
Afterward, do not spray water in the patients mouth since this creates cold sensitivity in most patients. Why impact their comfort this late in the game?