SKILL DEVELOPMENT FOR DENTAL NURSES: A SERIES
By Rosie Connell
SOFTLY, SOFTLY…Oral Health ADVICE
If you’ve ever given one of your dentists’ patients oral health advice, congrats, you know now how a stand up comedian feels. You’re whipping out your best material, ripe with accurate information (whilst working within your professional boundaries). But sometimes, what you are telling the patient can easily end up being a bit of a flop. They bought the ticket, but clearly didn’t enjoy the show!
Often this comes down to the patient and their general attitude towards dental visits and oral health.
Maybe the patient becomes argumentative, disengaged or upset whilst you are giving your best circular motion brushing technique demonstration. You shined your model up and everything!
We all know our surgeries, for some patients, are not on their top 100 places-to-be list, and this feeling can manifest in several negative ways.
I started being more proactive with offering OH advice during my time working as a locum in the military. The dental Officer loved me doing it. She could get on with some notes and didn’t have to repeat OH advice 10 times per day. In a setting where most patients were male and adhering to the norm of rankings, I had my fair share of tricky sergeants to advise. They didn’t want to listen, they were there on orders not their own free will. One patient blatantly answered his phone whilst I was mid sentence and another laughed and said; ‘I am a grown man, I obviously don’t need you to tell me how to brush my teeth!’ – Sorry big guy, but your plaque score tells a different story!
During my time in the NHS, a patient went to the reception crying, after I had asked some basic questions about her children’s OH routines. Although, what I said was correct, and the patients were high risk and desperately needed preventative advice, (which I did not even end up delivering to them by the way, as I could sense tension). I had to reflect on this event and identify how I can prevent this from happening again.
This kind of patient reaction can happen to the best of nurses and dentists alike, but the show must go on!
So I am now going to share some of my acquired tips when offering the patient oral health advice, without causing tension or upset.
- Be confident! Patients are like sharks, they sometimes bite but more importantly, they can sense fear! Confidence will develop naturally over time but at the beginning you might have to fake it. Good eye contact, a dazzling smile and clear, concise delivery should get you started.
- First, Copy the dentist, then make it your own. All dentists have their own tailored OH script, they may recommend a different brush or explain in different ways. Listen, and adopt their phrasing if you are giving advice for them. Once confident with this, you can start tweaking to make it your own, so it comes across more natural. I’ve picked up some great one liners and expressions along the way.
- Stay away from ‘command’ words. For me, I found certain words or expressions just don’t feel great in this kind of situation. Words like ‘you should’ or ‘you need to’ can make the patient feel like they are being told off, and can end up demotivating them. Replace these kind of commands with; ‘would you be able to try..’ or ‘the easiest way I find to do it is..’ These kind of soft-edged and suggestive expressions, ease the patient into the advise and make them feel part of the change making.
- Stick to 2-3 key pieces of advice. Any advice we give to patients, gets stored in their working memory, this area can only retain very few, new bits of information. Don’t waste your time telling the patient everything you know about tooth brushing, if what they really needed to work on was inter-dental cleaning. Pick key messages according to their current OH routine. For example, if a patient has dentures, I might focus more on that, rather than diet advice.
- Give a written copy. Patients feel a lot more comfortable when they are not panicking about remembering everything you say. Let them know very early on that you will give them all the advice to take home. For example, I just say something like ‘I am going to give you some oral health tips to take home but I’ll just go through some main things now so you can ask any questions.’ They will then be able to listen a bit more re-actively and ask questions rather than feel worried about forgetting things. Your practice might have an OH handout or you can make your own. But make sure the dentist is happy with what you are giving the patient. Plus, only give 1 leaflet at an appointment, if you give the patient too much paper material, they will see it as a bigger chore and are less likely to do it. Kindling anyone?
- A few last general tips: use a soft tone of voice, don’t rush, let the patient interrupt if they want to and lastly, take pride in your work.
Okay, go, you’re free now! I hope you enjoyed my tips for OH advice delivery. I find this is definitely a continuous, learning experience, you might change up a few things along the but don’t be afraid to try what works for you.
Come back for more skill tips!! Next time, I’m going to talk about talking. I’ll be sharing my best tips and phrases that will develop your ability to talk to any patient about anything to fill those awkward silences.
Our course Online Oral Health Course provides excellent advice should you need a brush-up
Ciao for now!!