An Analogy Roundup
Getting a patient to comprehend, and then accept, a treatment plan is a very important aspect of our jobs as dental hygienists. If a patient doesn’t accept a treatment plan, it benefits neither party. The patient doesn’t receive the necessary dental care, and the office doesn’t receive the production to support their employees.
Increasing case acceptance is something that is usually learned as you go in dentistry and catered to each patient. It is very important to be able to explain treatment needs in an efficient manner. One technique I find useful is using simple analogies to create a comparison between two things. This typically helps to clarify the treatment plan and create a better visual for the patient. For example, in my practice I state:
“You have a (Mild, Moderate, Severe) infection in your gums where bacterial toxins have caused your body to destroy the bone that holds your teeth in.
ANALOGY TIME: Think of your teeth like a fence post, you want a lot of dirt around that post to keep it strong and sturdy. If you lose some of the dirt, or bone, then the tooth can become mobile and possibly be lost.
To prevent this from progressing you will need a therapy (avoid saying deep cleaning) where we remove all of the toxins off of the teeth so that the disease doesn’t progress.”
From there I then go on to explain that the patient needs each quadrant treated with specialized therapy, instruments, and products to stop the progression. My hope in using the analogy is to streamline the patient's ability to understand that they don’t want to lose any more “dirt/bone” around their teeth and therefore accept the treatment plan. In discussing this with other hygienists I found that we all use several analogies to all get to the same result of case acceptance.
Below is a list of many analogies used by hygienists that you may feel helpful in incorporating into your practice. If you use a different one that works well let us know.
PERIODONTITIS
Periodontitis is like diabetes; it can only be controlled but not cured, so it's important to do perio maintenance appointments and practice good home care to keep it under control.
Periodontal disease is like a termite eating away at the bone. You don't know you have it until it's too late
Explaining periodontal therapy like weeding a garden-the calculus is the weeds and you can't have a good looking garden with weeds everywhere.
PERIODONTAL PROBING
Perio pockets are like cleaning under fingernails. 1-3 is normal fingernails and 4+ is when you start getting into the long fake ones.
Explain probing depths by referring to my hand in a fist as a tooth, and my sleeve is the gums.. and use my finger to act as a probe to show how we measure/what we're measuring
PERIODONTAL POCKETS
Perio pocket is like gutters on a house and they need the leaves cleaned out
When measuring perio pockets for perio charting, I explain that it's like wearing a turtleneck sweater. You can put your finger in the first inch or so because it doesn't fit tightly around your neck, but further down, the turtleneck is hugging your neck more snugly. Your teeth and gums are sort of like that. There is a pocket around each tooth that should normally be 1-3 mm deep, then your gums are attached to the tooth. Then I go on to explain how cleaning pockets deeper than that is difficult etc.
Teeth are little castles and the motes are the pockets where all of the BAD nasty critters live
SENSITIVITY AFTER PD
Sensitivity after calculus is removed is like someone ripping a blanket off of you....you get that initial cold shock and then you get used to it.
CALCULUS
Calculus acts like a sliver under your tissues. If you had a sliver in your hand and you left it in there, your hand would get red, irritated and start bleeding. Same thing happens under your gums if plaque is left behind to harden.
Calculus is like barnacles stuck on the teeth.
RADIOGRAPHS
When patients deny X-rays, I ask them "Would you let a mechanic fix your car without lifting the hood? They can't see through the hood and we can't see through the teeth to diagnose."
BRUSHING TECHNIQUES
Brushing your teeth is like cleaning fine China. Clean them gently with a soft brush, not scrubbing aggressively with a hard brush.
When brushing, imagine you are jeweler shining pearls & diamonds. The softer the brush, better the shine.
Brushing "hard " is like using an eraser. Scrub too hard-the paper gets all torn up…go gentle and it gets the job done!
Does your scalp bleed when you brush your hair? Uour gums shouldn't bleed when you brush your teeth either.
Tell them when you dry brush with the toothbrush it's like "sweeping before you mop".
Don't rinse with water after brushing with toothpaste you don’t want to wash away all of the product. Would you moisturize your skin and then take a shower?
FLOSSING
When a patient complains that they don't floss because they bleed, I say it's like going to the gym for the first time in a long time. At first you're sore (like your gums bleeding) but when you do it like you're supposed to, you're not sore (and your gums don't bleed).
Flossing is like washing your hands without cleaning between your fingers and once you start the habit, it's like working out. I demonstrated with my hands and the faces I see are priceless!
Flossing is like cleaning the space between their finger and nail... and it gets just as dirty.
Starting to floss is like learning to play the guitar. Your gums/fingers will be sore at first but will toughen up the more you practice.
WATER PIK
Waterpik vs flossing: Waterpik is like washing your car with a hose, flossing is like taking a sponge to your car which will remove dirt better? Both together leaves it squeaky clean!
SEALANTS
Sealants are like putting grout on flooring, you use it to seal the cracks so no trash gets in them, we seal the teeth so no bacteria or foods get caught on the pits and fissures (little cracks).
CAN’T YOU JUST DO THE FREE CLEANING?
If you work on the crowns of the teeth before addressing what's going on UNDER the gumline, it's like putting a nice, pretty house on a shoddy foundation!
Compare it to trying to rinse a bowl you have used to microwave oatmeal- there is a sticky film that has to be scrubbed- teeth are smooth like the bowl, plaque is sticky like the oatmeal and must be mechanically removed with specialized instruments.
Doing a prophy instead of periodontal therapy is like going to a salon and only getting your ends washed and not your scalp and roots.
In your case, having a “regular cleaning" is like painting over rust.
It’s like you have a broken foot but you are asking me to give you a pedicure.
ELECTRIC TOOTHBRUSHES
Use electric brushes slow and let it do the work like driving a car slow through cars wash... if you drive through fast (like long swipe brushing), car doesn't get clean.
Have you ever mixed a cake mix by hand? It takes twice as long, and there is still lumps left behind, versus if you use a hand mixer. Power toothbrushes do a superior job in less time than a manual.
Would you rather wash your clothes by hand or with a washing machine? Teeth are the same.
IMPLANTS
Think of a bone graft as pouring cement for the foundation of a home; before getting a dental implant.
CROWN OVER RCT
Root canal tooth needs a crown: a tooth with a root canal is like a tree that has died. It still stands but it's no longer living and is weak and brittle. The crown is required to strengthen and protect it. (Or an apple without the core.)
ARESTIN
It's like trying to scrape ALL the peanut butter out of the jar, no matter how much you scrape you will never be able to remove every bit of it, the same goes with periodontal therapy, no matter how much I scale, irrigate, and clean below the gums, I'll never be able to remove all the bacteria. I explain how Arestin will continue to kill the bacteria causing the infection for an additional 21 days after treatment.
It's like taking out the extra full trash bag that has sat for however long they haven't been to the dentist. After you take the bag out, you need to bleach the can to get rid of the germs causing the smells. Without the Arestin, you haven't treated the entire problem.
LASER
Explain the laser by comparing their necrotic tissue to a bacteria harboring dirty kitchen sponge. I'm gonna get rid of the sponge! Or leaving a band-aid on a wound for months.
DENTURE CARE
Not taking dentures out at night is like never taking off your shoes. Eventually your feet would get nasty and infected, the same thing happens with your mouth
CARIES
Your tooth is like a peanut M&M. You have a hard outer shell (enamel) and inner softer chocolate center (Dentin) and the peanut is like a pulp or nerve. A cavity progresses slowly through the outer candy shell, but once it gets into the soft center it moves quickly to the peanut and needs attention before it reaches the peanut center.
We’d love to your know favorite analogy you use regularly! Which one’s work for you?