Practice Management

Two Contentious “C” Words In Dental Practice


Ron Weintraub


February 18, 2014

February 18, 2014

Two terms commonly used in many everyday dental practices are particularly contentious:


ClientHygiene departments in dental practices have been defaulting to the nomenclature that refers to those who traditionally have been called “patients” as “clients.” Although this transition may seem unimportant and only stylistically relevant, actually it implies a subtle, but important, shift in focus from a different relationship and sets of responsibilities within the practice. “Clients” are those who avail themselves of services offered by any professional organization, lawyer, accountants, real estate agents, or other certified professionals whereas “patient” is reserved for the provision of health services. The term “patient” implies an elevated sense of responsibility and trust predicated on a long-perceived and on-going perception of what a patient has the right to expect. Substituting the term “client” for “patient” downgrades the entire interaction.

CleaningThe often-heard casual reference to “book for your cleaning” is omnipresent. We hear this in many practices that run the gamut from sophisticated multi-providers to all other types of established practices. The all-inclusive reference to “cleaning” actually refers to a predictable recurring scheduled appointment that sometimes generates close to 50 per cent total production of the office. “Cleaning” actually refers to the scheduled recare or health maintenance appointment or the oral care preventive hygiene program. This crucial component of normative practice commonly delivered by an in-house dental hygienist or resident dentist is often comprised of crucial dental services depending on the actual needs of patients and may include the following:

  • Updating of medical history;
  • Visual examination of dentition and surrounding tissues in oral cavity and head and neck region;
  • Radiographic survey of hard tissues – full mouth series of periapical films or Panorex survey or merely bite-wing exposures;
  • Oral cancer screen;
  • Dietary analysis regarding caries inhibition;
  • Recording of any apparent abnormal appearing oral manifestations;
  • Performing full periodontal examination which would include pocket probing and depth recording on all surfaces of all the teeth;
  • Potentially active hand or mechanical debridement of all calculus accretions found supra and subgingivaly;
  • Taking diagnostics study models;
  • Possible review of previously suggested remedial treatment that had not yet occurred;
  • Oral hygiene instructions and review of homecare;
  • Possible review of previously suggested remedial treatment that had not yet been addressed.

Many of these procedures are routinely incorporated in the average, albeit misnamed, “cleaning appointment.” Besides being the backbone of the patient base’s perception of what they expect from their dental office, the recare department often interacts with them more frequently and for longer time than any other component of the dental office. Patients often develop close, lasting relationships with their recare provider and sometimes depend on their input in making treatment decisions. Over the years, the role of recare providers has evolved from the posture of “You’re my dentist. I expect you to scale my teeth” to “Why are YOU doing this? Don’t you have a dedicated person for this?” If the answer is no, the question in patients’ minds is whether this is a sufficiently contemporary office to give the total care they may need. It also impedes the trust that people need in 

order to refer their friends and family to their practice. Recognizing the reality of the crucial standing that recare really possesses in today’s contemporary dental practice, in many of our projects, we have appointed a dedicated recare coordinator. Yet, we still have some dentists, hygienists, and administrative staff who continue to refer patients to book for their “cleaning” or call back to book for their overdue “cleaning” appointment.

It’s hard to reconcile a one hour $170.00 appointment when it is referred to as “just a cleaning appointment.” A small adjustment to change the phrase from “let me book your next cleaning appointment” to “let me book your oral health recare appointment” promotes a positive perception of the care reflective of patients’ expectations from healthcare professionals. Historically, appointments most susceptible for short term cancellation are recare appointments particularly when presented as unimportant as when using the terminology “just a check up and cleaning.” It reflects a lowered awareness of the value of “just a check up and cleaning” with the connotation that nothing much is lost if put off for another time.

Knowing the deleterious effect of using the common words “client” and “cleaning,” and phrase “just a check up and cleaning,” one would think that it would be easy to substitute more appropriate terminology. Such a paradigm shift, however, requires retraining of all the players in the office to consciously use the more appropriate “Patient and preventive recare appointment.” It is not easy to change habits; semantic expressions die hard. PA