Humanism and empathy are all the rage in today’s medical literature and are increasingly emphasized in the education process. We select applicants who display these virtues or in whom we think we can cultivate them. They’re even recognized by national societies like the Arnold P. Gold Foundation, of which I am I a member. All of this in an attempt to put an end to the pateranlistic medicine of the past, in favor of “patient-centered” care.
Ask healthcare providers how they feel about taking care of their own, and there are two schools of thought: 1) I should go above and beyond the call of duty for my fellow providers (this is by far more prevalent) and 2) I can be as curt and efficient as I like – they’ll understand! Recently, I had an experience in which a healthcare provider must have believed the latter and suspended her empathy towards me.
I’ll begin by saying this – the only thing I hate more than changing dentists, is changing mechanics. I don’t trust just anybody to work on my teeth or my car. Unfortunately, moving to California for my medical residency precludes me from seeing my regular dentist in New York.
Having skipped breakfast for the sake of the dentist’s visibility, I really wasn’t happy about how late the clinic was running – my name wasn’t called until an hour after my scheduled appointment. One of the assistants led me to the exam room, got me in position, and verified my information.
A young woman walked in and began fussing around with my records. She asked the assistant a couple of questions and then positioned herself over me. She picked an instrument up off the table and moved it toward my mouth, while I stared back at her, bewildered.
“Oh, sorry. I’m Dr. Dentist.”
Well, that’s better, I guess. If I had obediently opened my mouth, would she have introduced herself, I wondered? A quick acknowledgement about running behind schedule would also have gone a long way.
She resumed her work and asked what brought me in; I explained that I had just moved to town and was just beginning my residency. During the exam, she began calling out the work she would like to do while her assistant recorded it. She matter-of-factly stated that my wisdom teeth needed to be removed – I had achieved a tenuous armistice with my old dentist on this issue, and I was really missing him at this point.
“Do you floss?”
I told her that I like to use those combination floss pick doo-dads. She let out a disappointed “Hmm” and told me they weren’t as good as traditional floss because of a lack of maneuverability. And that was it, there were more tools in my mouth. End of discussion.
I mean, come on – no one flosses. That conversation must be the dentist’s equivalent of our “What are you doing about your weight?” conversation. But instead of a supportive “Well, I don’t like that, but it’s better than nothing” I received disapproval.
Now wait a minute. First, you don’t know how I use those things – I’m pretty thorough! Second, you know I’m a doctor – show me the research! At least say “studies show” or “it was shown that . . .”
Needless to say, this nagged at me to the point where I took it upon myself to look it up later that day. I was happy to find, almost immediately, two studies demonstrating at least that floss picks were “non-inferior” to traditional floss.
In the first study, the floss pick group was able to remove 19.4% of plaque compared with the control group’s 15%. The second study showed that in addition to removing more plaque, floss picks were better at reducing gingivitis.
These were small studies, and this is not an endorsement of these products, nor am I encouraging you to ignore the advice of your dentist. I’m just sharing an experience that was, to me, a reminder of how easy it is to alienate your patients. And when things like this happen to me, or to my family and friends, they serve as reminders for me to try to avoid such mistakes with my own patients.
Abnormal Facies 
wkolorzenieba
May 6, 2014
Have read your article and I would like to note a few things.
Regarding these studies – it is hard to talk about the success or failure of the experiment, which was performed on such a small group. Besides, using a (standard) floss for each interdental space we introduce “clean” piece. Using FlossPicks bacteria move from one space to another. I would like to note that the composition of the plaque (under-and over-gingival) is so different and also depends on the degree of development of plaque. Also, in the course of inflammation of the gums (chronic, acute, aggressive, purulent) there will be different strains of bacteria, which can easily transfer to another tissue.
Using a single piece of dental floss is like a car washing with one rag, starting from wheel covers and ending on the windows. Like a washed, but like it’s not.