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This Will Feel Like I’m Ripping Your Head Off

Published on: May 11, 2022
 By: Dr. Joe McEnhill
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Language can be romantic, evocative, flowery, or it can be brutal, ugly, and sometimes terrifying. It can give someone butterflies or lead to utter devastation and abject misery. One’s use of language can give patients an impression of an approachable and trustworthy person or a cold and arrogant clinician. Your choice of words can close a treatment plan, or you may never see that patient again. Naturally, this translates into the bottom line of your business and so it’s worth paying attention to the way we communicate with patients.

As dentists we invest a lot of time, money and energy developing skills and use a language that can mystify our patients. And it’s easy to speak jargon! How many times have we seen patient’s eyes begin to glaze over or they turn around to the dental nurse and asks them what they think? It is, of course, important to make a connection with a patient on their first visit. Establishing rapport goes hand in hand with trust and is of paramount importance if you hope your patient will accept your proposal. It shouldn’t be a sales pitch on fixing teeth if you hope to close the deal! Who gets excited about the prospect of getting nice new composite fillings? The patient is buying the result, not the treatment which is an important distinction.

You cannot underestimate the value of spending a few moments talking to the person in front of you. Perhaps avoid viewing them as your next cash cow, or a method to pay for your family vacation. Finding out a few pertinent facts about Fred or Sue helps them engage with you. How many kids have they got or what interests do they have? Then, importantly, write this on their notes to remind you for the next time. From the minute they are out the door, that pertinent fact I just learned has departed out my other ear! Imagine the legend you will be when in six months you ask Roger how he got on at his cup final. Some people are brilliant at remembering these little details, but I need prompting. The psychology of a person plays a large part, and we can talk about neuro-linguistic programming, or Freud’s psychoanalytical theories. But whilst understanding a person’s mind can be of value, simply being nice and having empathy goes a long way too.

I remember my wife’s bridesmaid recounting a story of her visit to the oral surgeon to get her wisdom teeth removed. I remember her anecdote being both horrific and hilarious in equal measure. As she was lying there feeling numb and ready to begin the procedure, her oral surgeon started by saying, “this will feel a bit like I am ripping your head off.” Perhaps there was an element of poetic license on the part of my friend, but she was never one for exaggeration. It is jaw dropping really. On what planet would this be considered an appropriate way to put anyone at ease, but it did make me laugh. I do sometimes enjoy schadenfreude, don’t judge! 

I really do not think that such dramatic and inflammatory language should ever be used if you are hoping to have a relaxed cooperative patient. I could imagine a few making a run for it if they were told this! It is a rare patient who is not apprehensive in some form or fashion at the prospect of a dental extraction, never mind a wisdom tooth. So, I will always begin by “gently wobbling the tooth to check movement and anesthesia. You will feel some pressure building but it should be totally comfortable.” It is also a psychological boost for the patient to be given an element of control rather than lying there and being utterly helpless. “Let me know if you need me to stop at any stage or if you are not happy in any way. Stop me if you need to take a breath or if you are feeling any pain.”

There are some fantastic oral surgeons posting on social media: @bloodytoothguy @pnwoms to name a few. Their video content hopefully is demystifying oral surgery and leads more dentists into learning a dental discipline that many avoid. Watching videos, however, does not make you an oral surgeon and the importance of hands-on courses and mentoring are critical. This is something I am hoping to address by teaming up with an old hospital colleague and teaching hands-on oral surgery.

Like many disciplines in dentistry, oral surgery requires a combination of skill, empathy and an ability to communicate. Whilst being empathetic is important, it is also of little use if you end up hacking that carious root out and leaving behind a bloody mess.  When extracting a tooth, I like to communicate to the patient that the goal is to remove the whole tooth comfortably and in a way that will give them as smooth a recovery as possible.

Is it possible that oral surgery can help grow your practice? Social media is currently awash with all the sexy treatments such as alignment, bleaching and bonding, the beautiful smile makeovers and the mediocre! Naturally, people like seeing these and it undoubtedly drives patients to your practice. But I have often been told that dental surgery is not a practice builder because patients do not enjoy the experience. This is an assertion I don’t wholly buy into. Whilst there is always going to be the patient who will make the speediest of escapes, I also have many patients who are full of smiles (somewhat lopsided granted) and gratitude that their extraction was much easier than expected. I am not so naive or arrogant to think that all my patients enjoy their extractions, but at the very least ensuring they do not have an unpleasant experience is an achievable goal. 

Another stereotype I have heard often is that oral surgeons (and implantologists) are often arrogant and on a testosterone fueled joyride. Not exactly a glowing report and certainly does not consider the increasing number of excellent female surgeons. It is certainly not a reputation I am happy to perpetuate. It all starts with treating patients with a level of humanity and not by “ripping their head off.”

Dr. McEnhill qualified from Queen’s University, Belfast, in 2000. He then relocated to Manchester to continue his education within the primary care field. After developing a keen interest in dental surgery, Dr. McEnhill joined a leading Manchester maxillo-facial unit enabling him to participate in major reconstructive surgery, notably by employing dental implants.

It was in this post that Dr. McEnhill gained his Membership of the Faculty of Dental Surgery, Royal College of Surgeons in Edinburgh. Dr. McEnhill returned to his native Enniskillen in 2005 to take up a position in his family practice. He has continued with his postgraduate training achieving a Diploma in Implant Dentistry in addition to an advanced certificate representing his bone grafting capability. This was awarded by the Royal College of Surgeons in England and is the gold standard.

Dr. McEnhill has travelled the world to learn new techniques including many trips to Germany, Spain and England. He spent a week studying in Brazil under one of the world’s foremost authorities in cosmetic dentistry. This encompasses not only teeth, but takes into consideration gums, lips, and facial harmony; all of which amounts to beautiful symmetrical and harmonious results. Dr. McEnhill is an active member of the Irish Association of Aesthetic Dentistry and is frequently traveling to various conferences around the world. As recognition of the high standard of Dr. McEnhill’s treatment he was awarded the Best Young Dentist in Northern Ireland 2011.

Dr. McEnhill is not one to sit still and is always looking to learn the latest techniques. Just as he is about to complete a one-year course in restorative dentistry he will begin another course in advanced occlusion; for many this is the cornerstone of predictable long-lasting dentistry. 

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